Treatment
Treating an Acute Attack in the Hospital. An acute attack may require hospitalization. Laboratory tests, an electrocardiogram (ECG), and a chest x-ray are performed to determine lung function, oxygen levels, and other indications of severity or rule out other causes. Depending on the results, the following treatments may be given:
- Beta2-agonists are the standard therapy. They may be administered with a nebulizer (a device that administers the drug in a fine spray) or given hourly with an inhaler. Studies are suggesting the use of inhaler is equally or possibly more effective than a nebulizer. Intravenous delivery is not recommended in most cases.
- A corticosteroid (commonly called a steroid) given within the first hour helps reduce the need for hospitalization. Steroids are typically administered intravenously or as an injection in adults. Lower doses work as well as higher ones in these situations.
- Intravenous magnesium opens airways and is an important emergency treatment for patients with very severe asthma.
- Oxygen is usually administered, and can be life saving in severe cases.
- In life-threatening situations, the patient may require mechanical ventilation.
- Antibiotics are not useful for asthma attacks if there is no strong evidence of the presence of a bacterial infection. (Viral infections, most often colds and flus, are more likely to trigger an asthma attack. In such cases, antibiotics do not appear to be beneficial and may have adverse effects.)
Discharge and Relapse After Hospitalization. It typically takes 3 to 4 hours to determine if a patient can be safely sent home or if they need to stay in the hospital. Patients are generally discharged under the following circumstances:
- When symptoms are gone or are minimal, and
- The peak expiratory flow rate is 70% or more of the predicted rate
Discharged patients generally take oral corticosteroids for 5 to 7 days. Despite reasonable precautions, about 20% of patients relapse within 2 weeks, although the risk is very low if they keep taking their medication after they leave.
Previous Section
