B.C. is a 3-year-old, 16-kg boy with a 1.5-year history of recurrent wheezing 3 days per week and nocturnal awakenings four times per month. His medications include albuterol syrup (2 mg/5 mL) 1 teaspoonful three times a day (TID) and albuterol metered-dose aerosol inhalation QID PRN for wheezing. B.C. demonstrates the use of the inhaler with his mother’s assistance. The mother holds the inhaler in B.C.’s mouth and actuates it at the end of a deep inhalation. B.C.’s mother tells the clinician that he appears “jittery” after taking albuterol syrup. What is the first step in deciding how to improve B.C.’s long-term drug therapy? What would be a reasonable initial regimen for B.C.?
[Solved]: B.C
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