Which medication class should be avoided until a SABA and ICS have been correctly utilized?

Long-acting beta agonists (LABAs) should be avoided until a short-acting beta agonist (SABA) and inhaled corticosteroid (ICS) have been properly utilized because LABAs are intended for maintenance therapy in asthma or chronic obstructive pulmonary disease (COPD) and are not appropriate for rescue treatment. SABAs are the preferred choice for immediate relief of acute bronchospasm due to their rapid onset of action. ICS are crucial for controlling underlying inflammation.

Using LABAs as monotherapy can increase the risk of adverse outcomes, including severe asthma attacks, especially in patients whose symptoms are not adequately controlled by SABAs and ICS. Therefore, the correct sequence of therapy starts with the use of SABAs for immediate symptom relief and ICS for long-term management and inflammation control, establishing a safe and effective treatment regimen before introducing the long-acting agent for more stable management of chronic symptoms.

In contrast, the other classes of medications listed can serve different roles. Short-acting beta agonists are essential for immediate symptom relief. Leukotriene receptor antagonists and anticholinergics can also be utilized in various scenarios but are not first-line treatments in acute situations like LABAs are. Hence, using LABAs requires prior management with