[Answered]: B

B. L. is a 61-year-old man who presents to the emergency department with a three day history of progressive dyspnea, couch, and increased production of clear sputum. The patient has long-standing chronic obstructive pulmonary disease (COPD). His home medications are formoterol and budesonide (Symbicort), and albuterol MDI for exacerbations. In this event, he treated himself with albuterol MDI, but his respiratory distress did not improve despite multiple inhalations. Upon arriving at the emergency department, there were few breath sounds heard upon auscultation. He was placed on 4 L of oxygen via nasal cannula and given nebulized ipratropium and albuterol treatments. A chest x-ray was taken demonstrating hyperinflation with flattened diaphragm, diffuse scarring and bullae in all lung fields, especially in the lower lobes bilaterally, and no infiltrates or effusions seen. Arterial blood gases (on 4 L O2 by cannula) pH 7.32 PaO2 65 mm Hg PaCO2 54 mm Hg SaO2 90% The patient was admitted to hospital and prescribed azithromycin for bilateral pneumonia. The patient was placed on formoterol and albuterol. What is the purpose of being on two different types of bronchodilators? How does an inhaled glucocorticoid drug help to control COPD? Provide 2 examples. Would you recommend that the patient would benefit from home oxygen? Why or why not?