Which medication should be added to a patient's treatment plan for better management of dyspnea in someone with chronic obstructive pulmonary disease (COPD)?

Adding inhaled tiotropium is a well-established strategy for managing dyspnea in patients with chronic obstructive pulmonary disease (COPD). Tiotropium is a long-acting anticholinergic inhaler that works by relaxing the smooth muscles in the airways and helping to open them up, which can significantly improve airflow and reduce breathlessness. It is particularly useful for patients who experience persistent symptoms, as it provides prolonged bronchodilation.

This medication not only helps in alleviating symptoms like dyspnea but has also been shown to reduce the frequency of exacerbations and improve the overall quality of life for individuals with COPD. When combined with other maintenance therapies, such as long-acting beta-agonists, tiotropium can enhance symptom relief and provide a more comprehensive approach to managing the disease.

While long-acting beta-agonists might also be effective in managing COPD symptoms, the addition of tiotropium specifically targets bronchoconstriction through a different mechanism of action, thus providing synergistic benefits when used appropriately. Increasing the dosage of salmeterol would not necessarily address the underlying mechanisms that contribute to dyspnea, nor would adding oral corticosteroids, which can carry a risk of side effects especially when used long-term.