K. L is a 26-year-old man with asthma. His symptoms have been well controlled with inhaled fluticasone and salmeterol. This morning he went for a short run and is now in the emergency department with an acute asthma attack that was not responsive to either of his inhalers. He is wheezing audibly, RR is 28, and O2 sats are 86% on room air.

a. What is the cause of wheezing during an asthma attack?
b. Why were the inhalers ineffective in aborting the attack?
c. Which medication should K. L. be prescribed to abort asthma attacks?
d. How should K. L. be reminded to use his inhalers on a daily basis? What are the major teaching points?