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Severe Asthma Attacks

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How Is a Severe Asthma Attack Treated?

A severe asthma attack may not respond quickly to routine treatment with asthma inhalers. Continuous use of an asthma nebulizer and injections of drugs such as epinephrine and corticosteroids for asthma are often necessary to stop the asthma attack. Other therapies may include terbutaline injections, magnesium sulfate (induces smooth muscle relaxation of the airways), and leukotriene inhibitors, which are anti-inflammatory drugs.

During a severe asthma attack that does not respond to asthma drugs, a mechanical ventilator may be needed to assist the lungs and respiratory muscles. A facemask is applied or a breathing tube is inserted in the nose or mouth for this asthma treatment. These breathing aids are temporary and are removed once the attack has subsided and the lungs have recovered sufficiently to resume the work of breathing on their own. A short hospital stay in an intensive care unit may be necessary with a severe asthma attack.

To avoid hospitalization with a severe asthma attack, it is imperative to begin immediate early treatment at the first sign of symptoms either at home or in your doctor's office. If you have asthma, it's also important to see your doctor frequently to monitor your lung function and to assess your asthma medications. Also, using your peak flow meter several times daily can help you monitor your breathing, so you can start treatment immediately if you notice a lower reading, even if you feel fine.

How Does Status Asthmaticus Differ From an Acute Asthma Attack?

An acute, or sudden, asthma attack is usually caused by an exposure to allergens or an upper respiratory tract infection. The severity of the asthma attack depends on how well your underlying asthma is controlled (reflecting how well the airway inflammation is being controlled). An acute asthma attack is potentially life-threatening because it may continue despite the use of your usual quick-relief medications (inhaled bronchodilators). When the acute asthma attack is unresponsive to treatment with an asthma inhaler (albuterol), this may then be status asthmaticus, where you'd need immediate medical attention and treatment.

Asthma attacks do not stop on their own without asthma treatment. If you ignore the early warning signs of an asthma attack, you put yourself at risk of developing status asthmaticus, which may require hospitalization for treatment.

If you have an asthma attack that does not respond to your usual bronchodilator inhaler, this is considered to be a medical emergency. These severe attacks require immediate emergency care.

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WebMD Medical Reference

Reviewed by Luqman Seidu, MD on May 18, 2014
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