A 72-year-old man is seen in clinic to review spirometry ordered for a 1-year history of morning cough and breathlessness when climbing one flight of stairs. He is an ex-smoker (40 pack-years) with no exacerbations or hospital admissions. Post-bronchodilator FEV1/FVC is 0.62 and FEV1 is 60% of predicted; his modified Medical Research Council dyspnea score is 1 and COPD Assessment Test score is 8. He has benign prostatic hyperplasia with urinary hesitancy, treated with tamsulosin, and a history of anaphylaxis to cow's milk. He has no history of glaucoma or urinary retention.
| Heart rate | 78/min |
| Respiratory rate | 16/min |
| Temperature | 36.8 °C |
| O2 saturation | 96%, room air |
| Blood pressure | 138/82 mm Hg |
Question 1 of 29
Given the patient's diagnosis, which one of the following is the most appropriate maintenance therapy at this visit?
Select 1. (0 / 1 selected)
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