title: Managing outpatient asthma exacerbations.
abstract: Asthma is a chronic inflammatory disease that renders individuals vulnerable to acute exacerbations. A wide variety of allergic and nonallergic triggers can incite an asthma exacerbation. The goals of managing an asthma exacerbation are prompt recognition, rapid reversal of airflow obstruction, avoidance of relapses, and prevention of future episodes. A written asthma home management plan is essential to minimize the severity of exacerbations. Short-acting beta-agonists, oxygen, and corticosteroids remain fundamental to early intervention in acute asthma exacerbations. Anticholinergics and magnesium sulfate can help nonresponders. Combination inhalers of the long-acting beta-agonist formoterol and inhaled steroid budesonide have been effective in flexible dosing in treating early acute exacerbations and as a daily controller medication outside the United States. Initiation or intensification of long-term controller therapy, treatment of comorbid conditions, trigger avoidance, and prompt follow-up can help prevent relapses. Listening to patient preferences and concerns enhances adherence, and regular follow-up care can help prevent future episodes.
authors.affiliation: Department of Pediatrics, University of Mississippi Med Ctr, Jackson, MS 39216, USA.
authors.forename: Sitesh R
authors.initials: SR
authors.lastname: Roy
authors.forename: Henry
authors.initials: H
authors.lastname: Milgrom
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000517:prevention & control; D001993:Bronchodilator Agents / Q000627:therapeutic use; D019819:Budesonide / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D004983:Ethanolamines / Q000627:therapeutic use; D000068759:Formoterol Fumarate; D006801:Humans; D008278:Magnesium Sulfate / Q000627:therapeutic use; D009330:Nebulizers and Vaporizers; D010045:Outpatients; D010100:Oxygen / Q000627:therapeutic use; D010349:Patient Compliance; D057240:Patient Preference; D012123:Pulmonary Ventilation; D055502:Secondary Prevention
chemical_list: D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D001993:Bronchodilator Agents; D002121:Calcium Channel Blockers; D018680:Cholinergic Antagonists; D004983:Ethanolamines; D019819:Budesonide; D008278:Magnesium Sulfate; D010100:Oxygen; D000068759:Formoterol Fumarate