A 67 year old man with long standing COPD characterized by chronic bronchitis is coughing up copious amounts of very thick white sputum. He complains that his chest feels tight, and he cannot catch his breath. His albuterol inhaler is not providing relief.
A. What bronchodilator is appropriate to add to the therapeutic regimen?
B. What alternative delivery methods might be useful?
C. What mucolytic may be considered if other means of sputum clearance are ineffective? Why might this drug be counterproductive?