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Acute Asthma Exacerbation: Treatment Options and Triggers of Asthma Attacks

The exacerbation of asthma symptoms, also known as asthma attacks, can cause distressing respiratory symptoms and anxiety. Different factors can trigger acute asthma exacerbations; it is important to learn how to reduce risks and when to seek medical assistance. 

Read on to learn more about asthma with acute exacerbations.

Asthma attacks or asthma exacerbations can be acute or subacute episodes during which your airways become swollen. When this happens, the muscles around your airways contract excessively, and the cells inside your airways produce disproportionate amounts of mucus. These changes cause your airways to become narrow, making it difficult for you to breathe properly.

The severity of asthma attacks is highly variable, and treatment will depend on how bad your symptoms are and how often you experience them. Minor asthma attacks may often be managed at home, whereas severe asthma exacerbations require urgent medical assistance and can even be life-threatening.

Asthma commonly affects children, but adults can also develop the condition, especially when they’re exposed to specific allergens. Women can be more susceptible to adult-onset asthma during certain stages of life, such as pregnancy, perimenopause, or menopause.

The symptoms of an asthma attack include:

  • Difficulty breathing
  • Shortness of breath
  • Chest tightness
  • Chest pain or pressure
  • Dry coughing
  • Wheezing when you exhale
  • Low readings in a peak flow meter (PEF)

The symptoms caused by an asthma attack can vary greatly from one patient to the next. Different factors, from the medications you’re taking to seasonal allergies, can even cause varying symptoms for the same patient.

The exact causes of an asthma attack can’t always be determined, but certain factors can increase your risk of having an asthma exacerbation, such as:

  • Exposure to allergens, such as smoke, pollen, pet dander, mold, and dust mites
  • Workplace exposure to chemical products or dust
  • Stress
  • Cold, dry air
  • Upper respiratory infections, such as the common cold or the flu
  • Cigarette or tobacco smoke
  • Gastroesophageal reflux disease (GERD)

Although anyone who has asthma can experience asthma attacks at any time, certain factors can increase the risk of developing severe asthma symptoms, such as:

  • Having experienced severe asthma exacerbations in the past
  • Having required urgent care or hospitalization for an asthma attack in the past
  • Using more than two rescue inhalers a month
  • Experiencing the sudden worsening of your symptoms during asthma attacks
  • Having been intubated during an asthma exacerbation
  • Suffering from another chronic disease, such as sinusitis, chronic lung disease, nasal polyps, or heart disease

If you have asthma, your doctor will prescribe a detailed treatment plan that fits your symptoms and needs. These plans usually include instructions for treating acute asthma exacerbations. It’s important to go over each step of this plan with your doctor to make sure you understand what to do in these cases.

Your doctor could prescribe quick-acting or rescue inhalers to be used when you develop acute asthma symptoms. These inhalers often include short-acting inhaled bronchodilators, such as albuterol, salbutamol, terbutaline, metaproterenol, levalbuterol, or pirbuterol.

You may be directed to take anywhere between two to six puffs to experience relief. Small children or other patients who have difficulty using inhalers properly could use nebulizers or inhalers with spacer devices — spacers feature a chamber that holds the medication in until the patient is able to inhale it. Your doctor’s orders may direct you to repeat the treatment after 20 minutes if your symptoms haven’t fully improved.

Seek immediate medical assistance if you experience severe asthma symptoms, such as having difficulty speaking, or if your usual relief medications don’t provide relief. In these cases, your health care provider could administer different medications to get your symptoms under control, such as:

  • Short-acting beta-agonists: these are the same medications featured in rescue inhalers, but they may be administered using a nebulizer
  • Oral or intravenous corticosteroids: these medications help relieve inflammation in your airways to improve airflow to your lungs
  • Ipratropium: this bronchodilator can be used to treat severe asthma attacks, especially when other medications fail to manage the patient’s symptoms
  • Intubation, mechanical ventilation, and oxygen: these procedures are typically reserved for patients who experience life-threatening asthma exacerbations that don’t respond to pharmaceutical treatment. In these cases, patients may need to be admitted to the intensive care unit (ICU) until their condition improves.

Once your doctor feels that your symptoms are under control, you’ll be discharged and able to go home. Your doctor could recommend using your rescue inhaler or taking oral corticosteroids for a few days after an asthma attack.

One of the most important steps that may be taken to reduce the risk of asthma exacerbations is to learn what triggers symptoms and avoid them. For example, if dry, cold air causes symptoms, it may be useful to cover your nose with a scarf in cold weather. Other strategies that can help to reduce the risk of acute asthma exacerbations include:

  • Wash your hands frequently and avoid touching your face to prevent getting colds or other respiratory infections.
  • Make sure you take each asthma medication as prescribed by your physician.
  • Regularly monitor your lung function using a peak flow meter and record your results.
  • Use your rescue inhalers as soon as you develop symptoms of an asthma attack.
  • Identify whether your use of quick-relief inhalers has increased lately. This could mean that your doctor needs to modify your treatment or adjust your doses. Never modify your treatment or self-medicate without talking to your health care provider first.
  • If a physical activity triggers an attack, stop immediately and use your rescue inhaler as prescribed.
  • Don’t stop taking your treatment or reduce your doses without discussing it with your doctor first, even if you feel that your symptoms are improving.

Asthma attacks can affect any patient who suffers from this chronic respiratory illness, with symptoms that range from mild to severe, and even life-threatening. The frequency in which patients experience asthma attacks can also be used to assess the severity of the disease and whether your treatment plan is working effectively.

It’s important for you to discuss your treatment plan with your doctor to make sure you understand the steps you need to take if you suffer from an asthma exacerbation. While mild asthma attacks may be successfully managed at home, severe symptoms can require immediate medical attention.

In addition to taking your medications as prescribed by your doctor, it’s important for you to identify your asthma triggers with your health care provider so that you can avoid them. By using these strategies, many patients may reduce risks related to their asthma and prevent frequent exacerbations.

https://www.mayoclinic.org/diseases-conditions/asthma/symptoms-causes/syc-20369653
https://www.mayoclinic.org/diseases-conditions/asthma-attack/diagnosis-treatment/drc-20354274
https://www.mayoclinic.org/diseases-conditions/asthma-attack/symptoms-causes/syc-20354268
http://www.jiaci.org/issues/vol20s1/7.pdf

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