Which medication is MOST likely associated with muscle wasting in a patient with chronic pulmonary disease?

Prednisone, a corticosteroid, is the medication most likely associated with muscle wasting in patients with chronic pulmonary disease. Corticosteroids have well-documented side effects, one of which is muscle wasting or atrophy, particularly when used over long periods. This occurs because corticosteroids can lead to protein catabolism and inhibit the synthesis of protein, which negatively impacts muscle mass and strength. In patients with chronic conditions like pulmonary disease, where maintaining muscle function is crucial for effective breathing and mobility, the risk of muscle wasting is particularly concerning.

In contrast, other medications listed do not carry the same risk for muscle wasting. Albuterol, a bronchodilator, primarily works by relaxing muscles in the airways, thus improving airflow, and is not known to cause muscle atrophy. Montelukast is a leukotriene receptor antagonist used to help control asthma and has no established link to muscle wasting. Ipratropium, another bronchodilator, works similarly by opening airways but does not have a significant impact on muscle tissue.

Thus, the association of prednisone with muscle wasting, especially in the context of a patient with chronic pulmonary disease, highlights its potential side effects and is a crucial consideration in their management.