Um, what?

I just received a PA request for budesonide respules for nebulization for an adult patient.  This is an asthma medication that is usually reserved for pediatric patients who cannot use an inhaler on their own, however, this office wants it for a runny nose.  Across the top of the form in large print is the following message: Please expedite, patient not expected to live much longer.  So, he is on his deathbed but must not have a runny nose...(?)  This is an asthma medication, what exactly are they trying to accomplish?  I had CatWoman look at it and she was a bit confused as well.  So, we denied it due to the need for a more logical rationale as it makes no sense on multiple levels. 

I feel bad that this man hasn't had a long life at all (in his 20's), but, this MD office needs to make sensible statements if they want us to approve a non-urgent medication for a man on his deathbed.  Right?