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Fadel Muhammad Garishah
Diponegoro University
School of Medicine
Diponegoro University
School of Medicine Pharmacology and Therapy I
Case I
A 56-year-old man presents to ED with the history of
shortness of breath for 45 minutes. He reports that he was
feeling well and in his usual state of health until about an
hour ago, when he smelled something burning. Twenty
minutes later, he began to fell short of breath and was
wheezing. He tried using his albuterol inhaler without
success, so he proceeded to the ED. At the ED, he was
tachycardia, tachypnea, wheezing and hypertensive. His
O2 sats on RA were 87% to 88%. His last admission for an
asthma attack was 2 months ago.
What is his acute asthma management?
Long term managements?
IgE
cysteinyl leukotrienes
Antiinflammatory drugs
Antiinflammatory drugs
Severe acute asthma is a medical emergency
requiring hospitalisation.
Treatment includes (Bronchodilators reverse the
bronchospasm of the immediate phase; anti-
inflammatory agents inhibit or prevent the
inflammatory components of both phases )
oxygen (in high concentration, usually 60%),
inhalation of nebulised salbutamol, and
intravenous hydrocortisone followed by a course of
oral prednisolone.
Additional measures occasionally used include nebulised
ipratropium,
intravenous salbutamol or aminophylline,
and antibiotics (if bacterial infection is present).
Monitoring is by PEFR or FEV1, and by measurement of
arterial blood gases and oxygen saturation.