A 68-year-old male with a history of severe COPD presents with increased dyspnea, cough, and sputum production for 2 days. He is afebrile, oxygen saturation is 88% on room air. After administering supplemental oxygen, what is the most appropriate initial pharmacologic intervention?

✓ Correct Answer: Option B

For acute exacerbations of COPD, inhaled short-acting bronchodilators (beta-agonists and anticholinergics) are the cornerstone of initial pharmacologic treatment to improve airflow obstruction. Corticosteroids are often added, but bronchodilators act more rapidly.