title: The evaluation and management of acute, severe asthma.
abstract: This article provides a systematic approach to the patient with acute, severe asthma. After a brief, focused evaluation prompt treatment with inhaled beta 2-agonists and systemic corticosteroids remains the cornerstone of treatment. Ipratropium bromide is now recognized as a useful addition for both adult and pediatric populations, whereas consideration of intravenous MgSO4 and theophylline is warranted for refractory patients. Ongoing evaluation of antileukotriene agents offers a possibility of these agents as alternative bronchodilators. Further research with a number of potential acute asthma agents will further expand treatment options for rapid symptomatic airway improvement and prevention of progressing airway obstruction, hospitalization, and potential respiratory failure.
authors.affiliation: Division of Pulmonary, Critical Care, Allergy, Immunology and Sleep Medicine, Henry Ford Health Systems, 4B One Ford Place, Detroit, MI 48202, USA.
authors.forename: Jaroslaw P
authors.initials: JP
authors.lastname: Siwik
authors.forename: Richard M
authors.initials: RM
authors.lastname: Nowak
authors.forename: Edward M
authors.initials: EM
authors.lastname: Zoratti
mesh_terms: D000208:Acute Disease; D001249:Asthma / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D012720:Severity of Illness Index