Rosh Emergency Medicine Practice Test

In managing a patient with chronic productive cough and shortness of breath, what medication is suitable for immediate treatment?

1. Short-acting beta-agonist

2. Intravenous antibiotics

3. Inhaled corticosteroids

4. Long-acting beta-agonist

The correct answer is: Short-acting beta-agonist

In this scenario, a short-acting beta-agonist (SABA) is the suitable medication for immediate treatment of a patient experiencing chronic productive cough and shortness of breath. SABAs work quickly to relax bronchial smooth muscle and relieve acute bronchospasm, leading to prompt improvement in airflow and reduction of respiratory distress. This is particularly important for patients who may be experiencing an exacerbation of an underlying condition such as asthma or chronic obstructive pulmonary disease (COPD), where bronchodilation is essential for quick relief. The immediate action of a SABA makes it appropriate choice when rapid relief of symptoms is necessary. In contrast, intravenous antibiotics would be indicated only if there is an underlying bacterial infection requiring immediate treatment. Inhaled corticosteroids are typically prescribed for long-term management and to reduce inflammation but do not provide immediate relief and may take time to exert their effects. Long-acting beta-agonists (LABAs) are also not suitable for acute symptoms because they have a delayed onset and are used primarily for maintenance therapy in chronic situations instead of for acute exacerbations. Thus, in the context of addressing acute symptoms of chronic bronchial obstruction, a short-acting beta-agonist is the most appropriate choice for immediate intervention.