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Abstract
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.
| Abbreviations | ||
| PEFR: | = | Peak expiratory flow rate |
| FEV1: | = | Forced expiratory volume in 1 second |
| FVC: | = | Forced vital capacity |
| ABG: | = | Arterial blood gas |
| ED: | = | Emergency department |
| MDI: | = | Metered-dose inhaler |
| LABA: | = | Long acting beta-agonist |
| FDA: | = | U.S. Food and Drug Administration |
| CS: | = | Corticosteroids |
| ICS: | = | Inhaled corticosteroids |
| IV: | = | Intravenous |
| VCD: | = | Vocal cord dysfunction |
| LTRA: | = | Leukotriene receptor antagonist |
| URI: | = | Upper respiratory infection |
| NHLBI: | = | National Heart, Lung, and Blood Institute |