American Board of Internal Medicine (ABIM) Certification Practice Exam

Which combination of medications is recommended for treating frequent acute exacerbations of COPD?

1. Indacaterol and salmeterol

2. Glycopyrrolate and fluticasone

3. Indacaterol and glycopyrrolate

4. Formoterol and budesonide

The correct answer is: Indacaterol and glycopyrrolate

The recommended combination of medications for treating frequent acute exacerbations of Chronic Obstructive Pulmonary Disease (COPD) is a long-acting beta-agonist (LABA) and a long-acting muscarinic antagonist (LAMA). Indacaterol is a LABA, while glycopyrrolate is a LAMA. This combination enhances bronchodilation and provides better control of symptoms compared to using either a LABA or a LAMA alone. In the management of COPD, particularly for patients experiencing frequent exacerbations, using both types of medications leads to improved lung function, a reduction in exacerbation rates, and enhancements in overall quality of life. This combination therapy can effectively target different pathways contributing to airflow obstruction, offering a comprehensive approach in the management of the disease. In contrast, the other combinations presented contain medications that may be used alone or in different settings but do not provide the specific dual action needed to address frequent exacerbations in patients with COPD. Thus, the combination of indacaterol and glycopyrrolate stands out as the most effective choice for this particular clinical scenario.