After not responding to a prescribed β2 agonist, which drug is the next option for a patient with asthma?

In the management of asthma, if a patient does not respond adequately to a prescribed β2 agonist, the next step often involves the use of a different class of medications to provide relief. Ipratropium, an anticholinergic agent, is particularly effective in the acute setting for patients experiencing bronchoconstriction. It works by inhibiting the action of acetylcholine on muscarinic receptors in the airway, leading to bronchodilation and mucus secretion reduction.

Ipratropium is often used in conjunction with β2 agonists and is especially beneficial for patients who may experience increased bronchospasm or those who have not had sufficient relief from beta agonists alone. This makes it a suitable next option for patients requiring additional bronchodilation in asthma management. Its rapid onset and additional bronchodilatory effects complement other treatments.

The other choices, while associated with different therapeutic uses, do not serve as second-line options for acute asthma management. Benztropine is primarily used for managing Parkinson's disease and extrapyramidal symptoms, oxybutynin is utilized for overactive bladder, and physostigmine is an acetylcholinesterase inhibitor used in specific types of poisoning and certain central nervous system disorders. Therefore,