Emergency outpatient treatment of asthma

The therapeutic aims in the treatment of severe asthma are to relieve bronchospasm, mobilize secretions and maintain alveolar ventilation. In emergency situations, adrenergic agonists by aerosol are the drugs of choice because of their speed of onset and potency. Intravenous aminophylline produces much less effect and data are accumulating that suggest that for most patients combined therapy with methylxanthines and sympathomimetics may not produce a greater response over that seen with sympathomimetics alone. Anticholinergics may be useful adjuncts, but their rate of onset is too slow to be used as first time therapy.