A 12-year-old girl with asthma presents to the emergency room with cough, dyspnea, and wheezing after visiting a riding stable. Which is the most appropriate drug to rapidly reverse her bronchoconstriction?

The most appropriate drug to rapidly reverse bronchoconstriction in this scenario is inhaled albuterol. Albuterol is a short-acting beta-2 adrenergic agonist that works by relaxing the bronchial smooth muscle, leading to bronchodilation. This action helps alleviate the acute symptoms of asthma, such as cough, dyspnea, and wheezing, especially in situations where the patient is experiencing an exacerbation due to triggers like allergens or irritants.

In contrast, inhaled fluticasone and inhaled beclomethasone are corticosteroids that are primarily used for long-term control of asthma by reducing inflammation and preventing exacerbations. They do not provide immediate relief of acute bronchoconstriction and are not effective as rescue medications.

Intravenous propranolol, a non-selective beta blocker, could potentially worsen bronchoconstriction as it would block the beta-2 receptors, which are critical for bronchodilation. Therefore, using albuterol is the preferred choice for immediate relief of acute asthma symptoms in this situation.