Asthma, Management of
📖 Asthma is a common airway disease and has a range of severity, from a very mild, occasional wheeze to acute, life-threatening airway closure. It usually presents in childhood and is associated with other features of atopy, such as eczema and hayfever.
💊 Medical management includes bronchodilators like beta-2 agonists and muscarinic antagonists (salbutamol and ipratropium bromide respectively) and anti-inflammatories such as oral or nebulized steroids. Theophylline was once popular but is rarely used due to its narrow therapeutic index and side effect profile. However, it is still important to note as there are patients still treated with it.
💊 Patients with life-threatening asthma are managed with high flow oxygen inhalation, systemic steroids, back-to-back nebulizations with short-acting beta 2 agonists, and short-acting muscarinic antagonists, and intravenous magnesium sulfate.
💊 Antibiotics should only be used if an infection is suspected (positive CXR, symptoms of cough and purulent sputum production, fever, high WBC, etc.) and should be withheld if not, to reduce the rise of antimicrobial resistance.