See also: COPD Exacerbation
Epidemiology
More common in male children than female children
More common in female adults than male adults
Higher prevalence in African-Americans than
Triggers
Exercise
Cold air
Aspirin or NSAID use
NSAIDs inhibit cyclooxygenase expression, which results in greater shunting of arachidonic acid metabolism through the lipoxygenase pathway producing leukotrienes, which are potent bronchoconstrictors.
Caucasians
Migrants who relocate from an area of low asthma prevalence to an area of high asthma prevalence tend to have an increased prevalence of asthma suggesting a role for environmental factors in the development of asthma
Tx of Asthma Exacerbation
IV and oral steroids are equally efficacious in treating an asthma exacerbation
In the setting of severe asthma exacerbation, a patient may have difficulty taking oral medications and the IV route is preferred
Salmeterol is along-acting beta2-selective adrenergic agonist that has no role in the treatment of an acute asthma exacerbation, but it is frequently preferred for outpatient ashtma management due to its BID dosing scehdule
Intubation may be required
Consider if PO2 does not improve with initial treatment
Consider if pCO2 inappropriately rises after initial treatment
