Jessica is a 37-year-old female diagnosed with mild persistent asthma.

Jessica is a 37-year-old female diagnosed with mild persistent asthma. During her visit today, she reports having to use her albuterol 4 days per week over the past month. Over the past week she has been using albuterol at least once per day. She reports being awakened by a cough five nights during the last month. Her current medications include: fluticasone HFA 44 mcg, two puffs BID, albuterol MDI two puffs Q 4-6 H PRN shortness of breath, Medrol Dosepak, metformin 500 mg PO BID, Inderal LA 160 mg po daily. Explain the problem and discuss how you would address the problem. How would you step up therapy for this patient? What medication changes would you make? When recommending medications, write out a complete prescription for each medication. What order would you send to a pharmacy? Include drug, dose, route, frequency, special instructions, # dispensed (days supply), refills, etc. Also state if you would continue, discontinue or taper the patient’s current medications. How would you monitor the effectiveness of this plan? What patient teaching would you provide? Answer questions using clinical practice guidelines. Provide scholarly reviewed references/sources to support scenario and include in-text citations.

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