Acute asthma exacerbation in adults

An acute asthma exacerbation in adults presents as an acute or subacute episode of progressive worsening of asthma symptoms, such as shortness of breath, wheezing, cough, and chest tightness.

Pulse rate, respiratory rate, subjective assessment of respiratory distress, accessory muscle use, and auscultation of the lung fields are key factors to assess during physical exam.

An increase in airway obstruction that can be quantified objectively by peak flow measurement or FEV₁ is typical in an acute exacerbation.

Early administration of bronchodilators and corticosteroids relieves airflow obstruction and helps to prevent future relapses. Severe exacerbations often require additional therapy including oxygen, magnesium, and, in some circumstances, mechanical ventilation.

Pneumonia, pneumothorax, pneumomediastinum, and respiratory failure are complications.

An asthma exacerbation is an acute or subacute episode of progressive worsening of symptoms of asthma, including shortness of breath, wheezing, cough, and chest tightness. Exacerbations are marked by decreases from baseline in objective measures of pulmonary function, such as peak expiratory flow rate and forced expiratory volume in 1 second (FEV₁).[1]Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. 2021 [internet publication]. https://ginasthma.org/gina-reports

This topic covers the management of adults. Children 12 years and older are generally treated the same as adults. However, consult your local pediatric guidance as there may be some differences in the treatment approach and weight-based dosing may be recommended in some adolescents.