[The treatment of asthma exacerbations in adults]

Asthma exacerbation is characterized by a rapid and progressive worsening of symptoms, mainly dyspnea, cough, wheezing and chest tightness. The intensity of an exacerbation may vary form a mild, transient worsening marked by a cough and moderate shortness of breath to a very severe and life-threatening condition. The clinical features of asthma include increased rate of breathing, cough, and prolonged and difficult expiration. The expiratory flow limitation could be quantified, objectified, and monitored by the lung function measurements (PEF or FEV1 ). It is of crucial importance to recognize properly the early signs of an exacerbation, judge its severity, and promptly start the treatments. The strategy of the treatment of an asthma exacerbation includes the repeated administration of rapid-acting inhaled bronchodilators, the early introduction of systemic glucocorticoids and oxygen supplementation. The treatment is aimed to resolve the airflow limitation and ameliorate the hypoxemia, as quickly as possible. Mild exacerbations could be treated in general practice while the severe ones should be treated in emergence units.