For which of the following patients would you recommend against using a flow-triggered me-tered dose inhaler (MDI) as the sole bronchodilator delivery system?
a. Patient likely to develop acute severe bronchospasm
b. Stable elderly patient on maintenance bronchodilator therapy
c. Teenage asthmatic who refuses to use a holding chamber
d. Patient who cannot coordinate MDI firing with inhalation
ANS: A
Caution may be appropriate in ordering breath-triggered pMDIs for small children and patients prone to severe levels of airway obstruction.
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