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Rational therapy of acute asthma
1Department of Medicine, University of California, San Francisco.
Annals of Allergy
|December 1, 1989
Summary
Asthma management requires objective measures of severity, not just subjective assessment. Early and aggressive treatment with bronchodilators and corticosteroids is crucial, with inhaled steroids aiding recovery by reducing airway inflammation.
Area of Science:
- Pulmonology
- Critical Care Medicine
- Pharmacology
Background:
- Asthma is a significant cause of emergency room visits and hospitalizations, with increasing mortality rates.
- Failure to accurately assess asthma severity contributes to poor outcomes and preventable deaths.
- Airway inflammation plays a key role in asthma pathogenesis, necessitating targeted therapies.
Purpose of the Study:
- To review current understanding and management strategies for acute asthma.
- To emphasize the importance of objective measures in assessing asthma severity.
- To discuss pharmacologic approaches for acute exacerbations and recovery phases.
Main Methods:
- Review of existing literature on asthma pathogenesis and treatment.
- Discussion of diagnostic tools for assessing airflow obstruction and gas exchange.
- Analysis of pharmacologic interventions, including bronchodilators, corticosteroids, and adjunctive therapies.
Main Results:
- Subjective assessment of asthma severity is unreliable; objective measurements are essential.
- Aggressive treatment with inhaled beta-adrenergic agonists and systemic corticosteroids is the primary approach for acute asthma.
- Inhaled corticosteroids are recommended during the recovery phase to mitigate bronchial hyperreactivity.
Conclusions:
- Accurate assessment and timely, aggressive treatment are vital for managing acute asthma and reducing mortality.
- Pharmacologic therapy should address both bronchodilation and airway inflammation.
- Inhaled corticosteroids play a role in post-acute asthma care to prevent recurrence and manage hyperreactivity.