12-06-2008, 06:12 PM
A 29-year-old woman is evaluated for exacerbation of her mild intermittent asthma over the past 6 weeks; she is awakened at night with wheezing, and has been using her inhaled β-agonist at least four times daily without improvement. She is 11 weeks™ pregnant. The patient has a 4-year-old child who is in day care, and they both have had a recent upper respiratory tract infection. The patient has a dry cough, clear nasal discharge, myalgia, and fatigue.
On physical examination, she is talking in full sentences and has normal tympanic membranes, a mildly erythematous oropharynx without exudates, no adenopathy, and positive wheezing bilaterally. Her peak airflow is 300 mL, with her baseline of 390 mL. Oxygen saturation by pulse oximetry is 96% on room air.
Which of the following is indicated in the management of this patient?
( A ) Antibiotic compatible with pregnancy
( B ) Theophylline
( C ) Leukotriene inhibitor
( D ) Oral pulse corticosteroid
( E ) Inhaled corticosteroid