PT  - JOURNAL ARTICLE
AU  - Maselli, Diego J
AU  - Peters, Jay I
TI  - Medication Regimens for Managing Acute Asthma
AID  - 10.4187/respcare.05953
DP  - 2018 Jun 01
TA  - Respiratory Care
PG  - 783--796
VI  - 63
IP  - 6
4099  - http://rc.rcjournal.com/content/63/6/783.short
4100  - http://rc.rcjournal.com/content/63/6/783.full
AB  - 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.