A 68-year-old male with a history of COPD presents with increased shortness of breath, cough with purulent sputum, and wheezing for 2 days. He uses home oxygen at 2 L/min nightly. His SpO2 is 90% on room air. Lung examination reveals diffuse wheezing and diminished breath sounds. What is the most appropriate initial pharmacologic therapy?

✓ Correct Answer: Option C

Acute exacerbations of COPD are typically managed with inhaled short-acting bronchodilators (e.g., albuterol, ipratropium) and systemic corticosteroids (oral or IV). Antibiotics are considered if there are signs of bacterial infection (e.g., increased sputum purulence). Long-acting agents are for maintenance, not acute exacerbation.