Respiratorymiddle twist
A 24-year-old woman with asthma since childhood attends for review. Her only treatment is a salbutamol inhaler, which she now uses three to four times a week for chest tightness, and she has woken twice in the past month coughing. She has never been admitted to hospital for asthma and required one course of oral corticosteroids a year ago. Her inhaler technique is good, she does not smoke, and spirometry today shows an FEV1 of 92% predicted. Which one of the following is the most appropriate treatment?