A 64-year-old man presents to his General Practitioner with a two-month history of worsening shortness of breath. He also has a chronic cough, which he attributes to his smoking. He has a medical history of stable angina. He uses sublingual nitroglycerin PRN (approximately twice a month) and takes no other regular medication. He has a 30 pack-year smoking history.

On examination, his blood pressure is 142/90 mmHg, pulse 86/min and temperature 36.9°C. He has poor inspiratory effort, and bilateral wheezes can be heard on auscultation.

SABA: short acting beta agonist, SAMA: short-acting muscarinic antagonist, LABA: long acting beta agonist, LAMA: long acting muscarinic antagonist, ICS: inhaled corticosteroid

Which one of the following inhalers would be the most appropriate for his immediate management?
Choose the single best answer.

• Indacaterol (LABA)

• Tiotropium (LAMA)

• Fluticasone (ICS)

• Ipratropium (SAMA)

• Eformoterol (LABA)