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Treatments and drugs
By Mayo Clinic staffIf you're having an asthma attack, follow the steps in the asthma plan you worked out with your doctor. If your symptoms don't improve, seek immediate medical care. Home treatment steps to stop an asthma attack generally include taking two to six puffs of albuterol (ProAir HFA, Ventolin HFA, others) or using other quick-acting medication over several minutes (don't take more than one puff at a time). Generally, less medication is needed for children and in adults with less severe symptoms.
If you use a peak flow meter to monitor your asthma, peak expiratory flow readings ranging from 50 to 79 percent of your personal best are a sign you need to use albuterol or other quick-acting (rescue) inhaler medication. Routinely checking your peak flow readings is important because your lung function may decrease before you notice any other signs or symptoms of worsening asthma.
Emergency treatment
If you go to the emergency room for an asthma attack in progress, you'll need medications to get your asthma under immediate control. These can include:
- Short-acting beta agonists, such as albuterol. These medications are the same medications as those in your quick-acting (rescue) inhaler. You may need to use a machine called a nebulizer, which turns the medication into a mist that can be inhaled deep into your lungs.
- Oral corticosteroids. Taken in pill form, these medications help reduce lung inflammation and get your asthma symptoms under control. For more-severe asthma attacks, corticosteroids can be given intravenously.
- Ipratropium (Atrovent). Ipratropium is sometimes used as a bronchodilator to treat a severe asthma attack, especially if albuterol is not fully effective.
- Intubation, mechanical ventilation and oxygen. If your asthma attack is life-threatening, your doctor may put a breathing tube down your throat into your upper airway. Using a machine that pumps oxygen into your lungs will help you breathe while your doctor gives you medications to get your asthma under control.
After your asthma symptoms get better, your doctor may want you to stay in the emergency department for a few hours or longer to make sure you don't have another asthma attack. When your doctor feels your asthma is sufficiently under control, you'll be able to go home. Your doctor will give you instructions on what to do if you have another asthma attack.
If your asthma symptoms don't improve after emergency treatment, your doctor may admit you to the hospital and give you medications every hour or every few hours. If you're having severe asthma symptoms, you may need to breathe oxygen through a mask. In some cases, a severe, persistent asthma attack requires a stay in the intensive care unit (ICU).
- Mangan JM, et al. What do patients need to know about their asthma? http://www.uptodate.com/home/index.html. Accessed Oct. 26, 2010.
- Krouse JH, et al. Asthma: Guidelines-based control and management. Otolaryngologic Clinics of North America. 2008;41:397.
- Fanta CH. Treatment of acute exacerbations of asthma in adults. http://www.uptodate.com/home/index.html. Accessed Oct. 26, 2010.
- Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm. Accessed Oct. 26, 2010.
- Li JT (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 4, 2010.
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