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  Authority of Polish Society of Allergology




vol 12. no 4. December 2007  
 TABLE OF CONTENT

 Postgraduate education
Management of acute asthma exacerbations
Krzysztof Kowal, Anna Bodzenta-Łukaszyk

Summary
Asthma exacerbations can be defined as episodes of progressively worsening of symptoms such as dyspnea, cough and wheezing with concomitant deterioration of the expiratory airflow. The main goals of therapy are reversal of bronchoconstriction and prevention of hypoxemia. The most effective bronchodilators are selective beta2-agonists with rapid onset of action. Treatment of asthma attacks should be introduced without any delay. Measurement of peak expiratory flow rate (PEF), which is the best objective parameter evaluating severity of asthma exacerbation and response to therapy, should be performed before beta2-agonists have been introduced. The preferred way for delivery of beta2-agonists is either by nebulization or by metered dose inhaler equipped with a spacer. Beta2-agonists are administered at high doses, which are several folds greater than dose used routinely by a patient. In severe asthma exacerbations corticosteroids should be introduced. They are administered either orally or parenterally. In a small proportion of patients addition of anti-cholinergic medication is associated with significant improvement of lung function. Improvement in lung function evaluated as increase in PEF after the first hour of intensive therapy is considered the best prognostic factor.

keywords: zaostrzenie astmy, beta2-mimetyki, nebulizacja, szczytowy przepływ wydechowy, asthma exacerbation, beta2-agonists, nebulization, peak expiratory flow

pages: from 171 to 176



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