Question

Your 23 year-old patient recently diagnosed with asthma cannot tolerate the CNS side effects of his inhaled albuterol (a beta-2 agonist bronchodilator). As an alternative, you recommend he try an inhaled quaternary antimuscarinic, and prescribe:

A. Atropine
B. Bethanechol
C. Ipratropium
D. Pyridostigmine
E. arenicline

Answer 1

C. Ipratropium

Step-by-step explanation:

The inhaled quaternary antimuscarinic that you can recommend as an alternative to inhaled albuterol for your 23-year-old patient with asthma is C. Ipratropium. Ipratropium is a medication that belongs to the anticholinergic class of drugs, and it is commonly used as a bronchodilator in the treatment of asthma and chronic obstructive pulmonary disease (COPD).

Answer 2

For a patient who cannot tolerate albuterol due to CNS side effects, ipratropium (Option C) is a suitable antimuscarinic alternative that is less likely to cause such side effects because it doesn't cross the blood-brain barrier.

Step-by-step explanation:

If your 23-year-old patient diagnosed with asthma cannot tolerate the CNS side effects of inhaled albuterol, an inhaled quaternary antimuscarinic option that can be recommended is Ipratropium (Option C).

Ipratropium is a bronchodilator that works by relaxing muscles in the airways and increasing airflow to the lungs. Unlike atropine, it does not cross the blood-brain barrier, which results in fewer CNS side effects. Other medications listed, such as atropine, have different indications and are not suitable for this purpose. Additionally, Bethanechol and Pyridostigmine have different mechanisms of action that would not be beneficial in the treatment of asthma.