In the case of a 36-year-old asthmatic patient who doesn't respond to metaproterenol, what is the next step?

In the case of an asthmatic patient who does not respond to metaproterenol, the correct next step involves administering systemic corticosteroids, such as methylprednisolone. This approach is appropriate because it addresses the underlying inflammation in the airways that contributes to the exacerbation of asthma symptoms. Systemic corticosteroids are effective in reducing airway inflammation and preventing the worsening of asthma, particularly when a patient shows inadequate response to bronchodilators.

While aqueous epinephrine is a rescue medication that may be considered in severe cases of anaphylaxis or acute asthma exacerbations, it is not the first line of defense or typically used in patients who have already been prescribed other bronchodilators. Albuterol is a short-acting beta agonist that is usually tried first in cases of acute bronchospasm, but since this patient has not responded to metaproterenol (another short-acting beta agonist), using albuterol would not address the inadequacy of the patient’s current treatment. Montelukast is a leukotriene receptor antagonist used for long-term management of asthma but is not effective in acute exacerbations. Therefore, initiating methylprednisolone is the most suitable intervention in this situation, focusing on managing the inflammation and enabling