American Board of Internal Medicine (ABIM) Certification Practice Exam

In treating mild intermittent asthma, which medication is typically prescribed as needed?

1. Daily Fluticasone

2. Indacaterol

3. PRN Albuterol inhaler

4. Tiotropium

The correct answer is: PRN Albuterol inhaler

In the management of mild intermittent asthma, the primary treatment approach focuses on providing rapid relief of symptoms when they occur. The medication commonly prescribed for this purpose is a short-acting beta-agonist (SABA) inhaler, such as Albuterol. This medication works by relaxing the muscles around the airways, leading to an immediate reduction in bronchospasm, thus alleviating symptoms like wheezing and shortness of breath. PRN (as needed) use of Albuterol is particularly effective for patients who experience asthma symptoms infrequently, usually less than two days a week. This aligns with the treatment guidelines that recommend SABAs for rescue therapy in such cases. While other medications, such as daily inhaled corticosteroids like Fluticasone, are important for long-term control in more persistent forms of asthma, they are not intended for immediate relief and therefore are not used on a PRN basis. Both Indacaterol and Tiotropium are also inhaled medications but are not the first-line treatment for acute symptoms in intermittent asthma. Indacaterol is a long-acting beta-agonist (LABA), and its use is typically reserved for individuals with more persistent asthma, while Tiotropium is a long-acting muscar