Q. A 28-year-old male presents to your clinic and states that his asthma, which he was diagnosed with in childhood, has gotten worse over the past 3 months. He reports increased use of his albuterol MDI from once a month historically, to 3-4 times per week. He recently moved into a new apartment in the basement of a house, and says his symptoms improve while he is at work. He reports no nighttime symptoms. He denies any fevers or other symptoms, and has no history of travel or occupational exposure.
On physical examination, he is afebrile and in no acute distress. His respiratory rate is 16 breaths per minute, heart rate 70 beats per minute, and his blood pressure is 118/65. Pulse oximetry demonstrates an oxygen saturation level of 95%. Cardiac examination shows regular rate and rhythm, and lung auscultation reveals high-pitched expiratory rhonchi bilaterally in the upper lobes.
What adjustments, if any, would you make to his medication regimen?