Management of the acute exacerbation of asthma.
All patients with asthma are at risk of having asthma exacerbations characterized by worsening symptoms, airflow obstruction, and an increased requirement for rescue bronchodilators. The goals of managing an asthma exacerbation are prompt recognition and rapid reversal of airflow obstruction to avert relapses and future episodes. Short-acting beta-agonists, oxygen, and corticosteroids form the basis of management of acute asthma exacerbation, but a role is emerging for anticholinergics and newer agents such as levalbuterol and formoterol. Initiation or intensification of long-term controller therapy, treatment of comorbid conditions, avoidance of likely triggers, and timely follow-up care prevent setbacks. Acceptance of current treatment guidelines by physicians and adherence to the recommended clinical regimens by patients are essential for effective management of asthma. The physician should strive to establish a constructive relationship with the patient by addressing the patient's concerns, reaching agreement on the goals of therapy, and developing a written action plan for patient self-management.
Roy
Sitesh R
SR
Department of Pediatrics, National Jewish Medical and Research Center, Denver, Colorado 80206, USA.
Milgrom
Henry
H
D000208:Acute Disease; D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy* / Q000628:therapy; D002675:Child, Preschool; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D015897:Comorbidity; D003937:Diagnosis, Differential; D004638:Emergency Treatment; D006371:Helium / Q000627:therapeutic use; D006801:Humans; D000860:Hypoxia / Q000503:physiopathology; D007223:Infant; D007275:Injections, Intravenous; D010100:Oxygen / Q000627:therapeutic use; D010102:Oxygen Inhalation Therapy; D017410:Practice Guidelines as Topic; D012648:Self Care
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D000893:Anti-Inflammatory Agents; D018680:Cholinergic Antagonists; D006371:Helium; C038949:heliox; D010100:Oxygen