Managing Outpatient Asthma Exacerbations

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, avoi...

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Bibliographic Details
Published in:Current allergy and asthma reports 2010, Vol.10 (1), p.56-66
Main Authors: Roy, Sitesh R., Milgrom, Henry
Format: Article
Language:English
Subjects:
Adrenal Cortex Hormones - therapeutic use
Adrenergic beta-Agonists - therapeutic use
Allergology
Asthma - drug therapy
Asthma - prevention & control
Bronchodilator Agents - therapeutic use
Budesonide - therapeutic use
Calcium Channel Blockers - therapeutic use
Cholinergic Antagonists - therapeutic use
Ethanolamines - therapeutic use
Formoterol Fumarate
Humans
Magnesium Sulfate - therapeutic use
Medicine
Medicine & Public Health
Nebulizers and Vaporizers
Outpatients
Oxygen - therapeutic use
Patient Compliance
Patient Preference
Pulmonary Ventilation
Secondary Prevention
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Summary: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 β-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 β-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.
ISSN:1529-7322
1534-6315
DOI:10.1007/s11882-009-0083-5