A patient with stable COPD receives prescriptions for an inhaled glucocorticoid and an inhaled beta2-adrenergic agonist. Which statement by the patient indicates understanding of this medication regimen?

Choice A reason: Hyperplasia and deformation of bronchial cartilage are not the causes of airway obstruction in COPD type B. Bronchial cartilage is the rigid structure that supports the bronchi, the large airways that branch from the trachea. Hyperplasia is an increase in the number of cells, and deformation is a change in the shape or structure of the cells. These processes can affect the bronchial cartilage, but they do not directly obstruct the airway.

Choice B reason: Loss of alveolar elastin is not the cause of airway obstruction in COPD type B. Alveolar elastin is the elastic fiber that allows the alveoli, the tiny air sacs at the end of the bronchioles, to expand and recoil during breathing. Loss of alveolar elastin is a characteristic of COPD type A (emphysema), which causes the alveoli to lose their shape and collapse. This reduces the surface area for gas exchange, but it does not obstruct the airway.

Choice C reason: Pulmonary edema is not the cause of airway obstruction in COPD type B. Pulmonary edema is the accumulation of fluid in the lungs, usually due to heart failure or lung injury. It causes shortness of breath, coughing, and crackles in the lungs. It can impair gas exchange and oxygenation, but it does not obstruct the airway.

Choice D reason: Thick mucus, fibrosis, and smooth muscle hypertrophy are the causes of airway obstruction in COPD type B. Thick mucus is the result of chronic inflammation and infection of the bronchi, which stimulates the mucus glands to produce more and thicker mucus. Fibrosis is the formation of scar tissue in the bronchial walls, which narrows the airway and reduces its elasticity. Smooth muscle hypertrophy is the enlargement of the smooth muscle cells that surround the bronchi, which increases the airway resistance and causes bronchospasm. These processes combine to obstruct the airway and cause chronic cough, wheezing, and dyspnea.

Choice A reason: Albuterol is not used to treat acute allergies. It is a bronchodilator that relaxes the smooth muscles of the airways and improves airflow. Antihistamines are the drugs of choice for acute allergies.

Choice B reason: Albuterol is not used to treat nasal congestion. It is a bronchodilator that acts on the lungs, not the nose. Decongestants are the drugs of choice for nasal congestion.

Choice C reason: Albuterol is not used to treat dyspnea on exertion. It is a bronchodilator that is used for acute or chronic respiratory conditions, such as asthma or chronic obstructive pulmonary disease (COPD). Dyspnea on exertion is a symptom of various cardiac or pulmonary disorders that require further evaluation and treatment.

Choice D reason: Albuterol is used to treat acute bronchospasm. It is a bronchodilator that quickly relieves the symptoms of bronchoconstriction, such as wheezing, coughing, and shortness of breath. It is often prescribed as a rescue inhaler for patients with asthma or COPD.