solved

A 25-year-old woman with a history of asthma and eczema presents to you with worsening shortness of breath over the last few weeks. She takes a low-dose inhaled corticosteroid as maintenance therapy. She has been using her albuterol inhaler on a daily basis with little relief of her symptoms. She awakens from sleep due to shortness of breath about twice a week.
On physical examination, she appears comfortable at rest but has inspiratory and expiratory wheezing in her lung bases.
Vital signs are: pulse, 86 beats/minute; blood pressure, 132/84 mm Hg; respiratory rate, 24 breaths/minute; temperature, 96.7°F (35.9°C); and oxygen saturation, 98% on room air.
In addition to her scheduled low-dose inhaled corticosteroid, which of the following medications is the preferred step-up therapy for this patient?

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