A 55-year-old woman with a known history of severe asthma and obesity presents to the emergency department with increased shortness of breath, wheezing, and coughing over the past two days. Her vitals are: blood pressure 140/90 mmHg, heart rate 110 bpm, respiratory rate 30 breaths per minute, and oxygen saturation 88% on room air. Despite receiving multiple doses of inhaled bronchodilators and IV steroids, her symptoms have not improved. You overhear the attending ask the medical resident to recommend the next step in management. What would be your response?

A 45-year-old woman with a known history of moderate persistent asthma presents to the emergency department with increased shortness of breath, wheezing, and coughing over the past day. Her vitals are: blood pressure 120/80 mmHg, heart rate 90 bpm, respiratory rate 22 breaths per minute, and oxygen saturation 94% on room air. She has been using her short-acting beta-agonist (SABA) inhaler frequently over the past few days with little relief. As a clinical pharmacist, you are asked to recommend an alternative treatment strategy based on the GINA 2023 guidelines. What would be your response?

A 24-year-old female with a known history of asthma presents to the Emergency Department. Over the past week, changing weather conditions have exacerbated her condition. Despite compliance with her regular medications, salbutamol and fluticasone, in the last 2 hours, she has experienced severe difficulty breathing and audible wheezing. The wheezing has since subsided. On the past year, she has had 2 exacerbations that required hospital admission. Based on her presentation, according to the Global Initiative for Asthma, which treatment option is most appropriate?

A 46-year-old male with comorbidities of hypertension and asthma presents to the emergency department with increasing breathlessness and chest tightness. His vitals include a respiratory rate of 30 breaths/min, heart rate of 115 bpm, blood pressure of 150/90 mmHg, and oxygen saturation of 88% on room air. The team decides to employ non-invasive positive pressure ventilation as a preferred mode of ventilation due to his acute asthma exacerbation, and a sedative is required to aid the process. Ideally, the sedative should not cause respiratory depression or bronchoconstriction in this scenario. Which of the following sedatives would be the most appropriate choice for this patient?

A 35-year-old woman with a known history of asthma presents to your clinic with symptoms of an asthma exacerbation. She has a heart rate of 134 beats per minute, SpO2 of 91% on room air, and is sitting hunched forward while appearing anxious. On auscultation, her chest is quiet with limited breath sounds. Which of the following is NOT a sign of severe asthma in this patient?