Acute bronchial asthma, hypersensitivity of the bronchial tubes leading to the lungs, causes bronchial constriction, swelling and inflammation in response to certain triggers, decreasing the amount of oxygen the lungs receive. Bronchial asthma affected approximately 300 million people worldwide in 2007, according to World Health Organization statistics reported by the American Academy of Allergy, Asthma and Immunology, and accounts for half a million hospitalizations a year in the United States according to the Centers for Disease Control's 2006 statistics reported on the same site. Acute bronchial asthma threatens a person's ability to breathe well and requires immediate medical treatment.
Bronchodilators
Bronchodilators open up the swollen bronchial tubes so more air can enter into the lungs during an acute bronchial asthma attack. Bronchodilators, usually inhaled medications, can be taken regularly on a long-term basis or used just in acute situations on a short-term basis. People who need to use rescue inhalers more than twice a week would benefit from taking long-term beta-2 agonists to prevent attacks, the Cleveland Clinic advises.
Short-term bronchodilators, sometimes called "rescue" medications, include short-acting beta-2 agonists, or SABAs, which work within minutes and last four to six hours, MayoClinic.com reports. Common SABAs include Maxair, Proventil, Ventolin and Xopenex. Atrovent, a bronchodilator usually used over the long term, may be prescribed for use in an acute asthma attack in addition to SABAs. Treatments may need to be "given frequently and in high doses" during an acute attack, states Reggie Voboril, M.D., University of Kansas-Wichita Medical Center. Bronchodilators can cause rapid heart rate, tremors, nervousness and hyperactivity, the Cleveland Clinic reports.
Oxygen
In acute bronchial asthma attacks, supplemental oxygen may be necessary to increase oxygenation throughout the body. Oxygen may be given through a mask; in severe attacks, a patient may need mechanical ventilation, with oxygen delivered via an artificial respirator, a machine that forces extra oxygen into the lungs. Oxygen saturation levels are monitored via pulse oximetry, with the goal of maintaining oxygen saturation at greater than 90 percent, according to Dr. Voboril.
Anti-Inflammatory Medications
Acute bronchial asthma causes severe inflammation and swelling in the bronchial tubes, further narrowing the already-constricted tubes. Anti-inflammatory medications, such as corticosteroids, reduce inflammation when inhaled or given intravenously or by mouth. Prednisone, methylprednisone and dexamethasone are commonly used corticosteroid medications. Side effects of corticosteroids include immune system suppression, increased appetite, high blood sugar, high blood pressure and mood changes, says Dr. Eric Rose of the University of Washington.
References
- MayoClinic.com: Asthma Medications
- University of Washington: Dr. Rose's Peripheral Brain; Eric Rose, M.D.
- American Academy of Allergy, Asthma and Immunology: Asthma Statistics
- University of Kansas-Wichita: Management of Acute Asthma Exacerbations: Reggie Voboril, M.D.
- Cleveland Clinic: Treating Asthma With Bronchodilators
