NOT A PAPER! Just place your answer below the question there’s only 2 questions


Case Study: Allergy and Respiratory Disorder Drugs – Asthma


After reviewing the case, please provide answers to the questions that follow.


Patient Presentation

Cecilia is a 65-year-old woman presenting to her primary care clinic for her annual check-up. Her last clinic appointment was approximately 1 year ago, 12/2018. She has had difficulty with her asthma for some time and reports that her activity has been somewhat limited due to her shortness of breath.


Chief Complaint

“I am here for my annual check-up.”




Coronary artery disease

Low back pain


Thrush from previous inhaled corticosteroid use



Father with COPD (smoked a pipe for 40 years). Mother with coronary artery disease and cerebrovascular disease.



She lives with her husband, who is a physician. When she had an MI at age 52. Currently smoking ½ ppd, for the past 30 years.



  • Aspirin 81 mg daily
  • Clopidigrel 75 mg daily
  • Rosuvastatin 20 mg daily
  • Lisinopril 20 mg daily
  • Metformin XR 500 mg BID
  • Ibuprofen 200 q 4-6 hours as needed
  • Albuterol inhaler 1-2 puffs q 4-6 hours as needed






(+) Chronic cough; (+) exercise intolerance


Physical Examination


General: Well-developed well-nourished female who appears her stated age. She appears in no acute distress currently.


VS: BP 110/68, P 60, RR 18, T 37°C; Wt 82 kg, Ht 5′9″; pulse ox 97% on RA


Skin: Warm, dry; no rashes


HEENT: Normocephalic; PERRLA, EOMI; normal sclerae; mucous membranes are moist; TMs

intact; oropharynx clear


Lungs: Decreased breath sounds; no rales, rhonchi, or crackles.


Vaccination Status

Flu: administered 10/2018

Pneumococcoal: administered 5/2009

Shingles: Zostavax administered 8/2015

1.What laboratory tests can be performed and how often should they be performed to assess the efficacy of the current asthma regimen as well as progression of the patient’s lung disease? Michele


2.What information should be provided to the patient to enhance adherence, ensure successful therapy, and minimize adverse effects? Michele