24th May 2025

A 65 year old female with COPD has been admitted after a fall.

A 65 year old female with COPD has been admitted after a fall. She is currently requiring her salbutamol reliever inhaler three times daily; however, she is not on any regular inhalers. She confesses that she feels wheezy on moderate exertion on a daily basis for the past few months. She denies fevers, weight loss and night sweats. A plain chest radiograph reveals hyperexpanded lung fields with no focal consolidation or collapse. Bloods show a white cell count (WCC) of 6.8 and a C-reactive protein (CRP) of 10. She has a diurnal variation in peak flow of 15%. What is the appropriate next step in the management of her COPD?

Select the SINGLE most appropriate option from the list below. Select ONE option only.