NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

At what step in the asthma treatment algorithm is it recommended to refer for assessment and consider adding additional medications such as tiotropium or oral steroids?

1. Step 3

2. Step 4

3. Step 5

4. Step 6

The correct answer is: Step 5

In the asthma treatment algorithm, Step 5 is where it is recommended to refer for assessment and consider adding additional medications such as tiotropium or oral steroids. At this step, patients have severe persistent asthma that is not well controlled with high-dose inhaled corticosteroids and a second controller medication. Therefore, referral for further assessment and the addition of medications beyond the typical inhalers are necessary to optimize asthma management for these patients. Options A, B, and D correspond to earlier steps in the asthma treatment algorithm and do not typically involve the consideration of tiotropium or oral steroids.