Reference of this article: Echávarri Olavarría F, Pérez-Lescure Picarzo J. Management of the acute asthma. Rev Pediatr Aten Primaria. 2005;7 Supl 2:S107-125.
Published in Internet: 30-06-2005
Before starting treatment for paediatric acute asthma a brief patient data must be obtained
about previous asthma history. Treatment should include the use of oxygen, shortacting
beta-adrenergic drugs, and systemic steroids. Mild and moderate asthma attacks can
be treated at the Primary Care Paediatric Office, where oxygen source and a pulsyoxymeter
device should be available. Drug dosage and administration schedules must be modified
in relation with the exacerbation severity and patient response to therapy. In severe acute
asthma, addition multiple inhaled ipratropium doses may bring some benefits to the betaadrenergic
drugs alone. The best way for both beta-adrenergic and ipratropium is inhaled
way, nebulization or inhalation with an inhalator and spacer, and it is necessary to be sure
that child use the spacer properly. Steroids have an excellent anti-inflammatory action, by
modulating the synthesis, liberation and activity of inflammation mediators, and its effectiveness
has been shown when used early and in a systemic pattern. The clinical effect of steroids is not immediate, therefore must not be the first nor the only drug used. Currently,
inhaled administration of steroids in the treatment of acute asthma exacerbation is not recommended.
In case of severe asthma exacerbation, there are other therapeutic options as
theophylline, magnesium sulphate, and other Intensive Care Unit measures if necessary.
Keywords● Acute asthma ● Asthma ● Drug therapy ● Paediatrics