Asthma Exacerbation
Posted by dkwinter

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