Medication regimens for managing acute asthma

Diego J. Maselli, Jay I Peters

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Asthma exacerbation is defined as a progressive increase in symptoms of shortness of breath, cough, or wheezing sufficient to require a change in therapy. After ruling out diagnoses that mimic an asthma exacerbation, therapy should be initiated. Short-acting β2 agonists and short-acting muscarinic antagonists are effective as bronchodilators for asthma in the acute setting. Systemic corticosteroids to reduce airway inflammation continue to be the mainstay therapy for asthma exacerbations, and, unless there is a contraindication, the oral route is favored. Based on the current evidence, nebulized magnesium should not be routinely used in acute asthma. The evidence favors the use of intravenous magnesium sulfate in selected cases, particularly in severe exacerbations. Methylxanthines have a minimum role as therapy for asthma exacerbations but may be considered in refractory cases of status asthmaticus with careful monitoring of toxicity. Current guidelines recommend the use of helium-oxygen mixtures in patients who do not respond to standard therapies or those with severe disease.

Original languageEnglish (US)
Pages (from-to)783-796
Number of pages14
JournalRespiratory Care
Volume63
Issue number6
DOIs
StatePublished - Jun 1 2018
Externally publishedYes

Fingerprint

Asthma
Status Asthmaticus
Therapeutics
Magnesium Sulfate
Helium
Muscarinic Antagonists
Bronchodilator Agents
Respiratory Sounds
Cough
Dyspnea
Magnesium
Adrenal Cortex Hormones
Guidelines
Oxygen
Inflammation

Keywords

  • Asthma exacerbation
  • Asthma therapy
  • Bronchodilators
  • Severe asthma

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Medication regimens for managing acute asthma. / Maselli, Diego J.; Peters, Jay I.

In: Respiratory Care, Vol. 63, No. 6, 01.06.2018, p. 783-796.

Research output: Contribution to journalArticle

Maselli, Diego J. ; Peters, Jay I. / Medication regimens for managing acute asthma. In: Respiratory Care. 2018 ; Vol. 63, No. 6. pp. 783-796.
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