According to Mayo Clinic, asthma attacks occur when the airways suddenly narrow and swell. This can cause symptoms of cough, wheezing and difficulty breathing. Not only are these symptoms distressing, they can become life-threatening if not treated promptly. If an asthma attack does not quickly respond to the medications a patient has at home, it should be treated in the hospital.
Causes
A patient with asthma has sensitive airways that become inflamed and swollen in response to certain triggers. These triggers are different for each person but include allergens such as mold, dust and pet dander, cold air, exercise, stressful or emotional situations, tobacco smoke, upper respiratory infections, and gastroesophageal reflux disorder. Once the airways become inflamed and symptoms begin, it is important to start taking the "rescue" medications that the patient has at home to help halt the asthma attack.
Symptoms
An acute asthma attack often begins with symptoms of cough and wheezing. These symptoms can become more severe and progress to severe shortness of breath, inability to speak in complete sentences, chest tightness and low readings on a peak flow meter. If symptoms do not initially respond, emergency treatment is needed.
Short-Acting Beta Agonist
According to the National Institutes of Health, the first line of treatment for an acute asthma attack is a short-acting beta agonist. This is a "rescue" medication or a medication that is designed to work quickly. Albuterol is an example of this type of medication and the patient inhales it via inhaler or nebulizer deep into the lungs. It helps to relax the muscles lining walls of the airways.
Anticholinergics
Anticholinergics are medications that also help to open up the airways in an acute asthma attack. According to the National Institutes of Health, these medications are used in the emergency setting when albuterol alone is not effective. One example of this type of medication is ipratropium bromide and it is inhaled in either an inhaler or nebulizer form. Anticholinergics are used in conjunction with albuterol to provide greater dilation of the constricted airways.
Corticosteroids
Corticosteroids, such as prednisone, are anti-inflammatory medications that can be given in either an oral or an intravenous formulation. In the setting of an acute asthma exacerbation, this medication is typically given intravenously in order to provide quicker response and because some patients have difficulty with swallowing in this setting. As discussed by the National Institutes of Health, this medication does help decrease airway inflammation and to prevent relapse once the attack is under control. However, it is not typically used long term because of side effects.
Other Emergency Treatments
Oxygen is frequently used in the setting of an acute asthma attack. Supplemental oxygen can help to increase the amount of oxygen that reaches the bloodstream while a patient is having difficulty with breathing because of constricted airways. Additionally, if the airways are so constricted that they are closing off or if the patient is extremely fatigued from struggling to breathe, intubation may be necessary. Intubation is a procedure in which a tube is placed down the trachea to enable a machine to assist the lungs with breathing. Once the treatment for the asthma attack becomes effective, the tube can be removed.
