What is the best course of action for Jamie, age 16, who has recent difficulty breathing at night despite previously well-controlled asthma?

In this scenario, the most effective course of action for Jamie, who is experiencing recent difficulty breathing at night despite previously well-controlled asthma, is to prescribe an inhaled steroid. Inhaled corticosteroids are considered the cornerstone of asthma management, particularly in patients who exhibit symptoms indicating a worsening disease state. They work by reducing inflammation in the airways, thereby enhancing control over asthma symptoms and reducing the frequency of nighttime awakenings due to breathing difficulties.

Jamie’s recent nighttime symptoms might suggest that her asthma is becoming poorly controlled, which often indicates a need to intensify treatment. Inhaled corticosteroids not only stabilize the condition but also serve as a preventive measure against exacerbations. This approach is especially important in adolescents, as they often experience fluctuating asthma control due to factors such as growth and lifestyle changes.

Other treatments like short courses of steroid therapy may provide temporary relief but are not a long-term solution and usually do not address the underlying inflammation. A longer acting bronchodilator could be part of a treatment regimen but is generally combined with inhaled steroids for optimal management rather than being used as a first choice for worsening symptoms. Oral theophylline is less commonly used due to its side effects and the availability of more effective and safer medications, making inhal