Question
Treatment of Status Asthmaticus
Q43 marksShort Notes
Answer
Status asthmaticus is a severe, life-threatening asthma exacerbation unresponsive to initial bronchodilator therapy.
Immediate management
- High-flow oxygen to maintain SpO2
- Nebulized short-acting β2 agonist (Salbutamol), repeated/continuous nebulization
- Nebulized ipratropium bromide (added to β2 agonist for synergistic bronchodilatation)
- IV/oral corticosteroids (e.g., Hydrocortisone, Prednisolone) — reduce airway inflammation, though onset is delayed (hours)
- IV Magnesium sulphate — bronchodilator effect in severe cases
- IV Aminophylline (second-line, if inadequate response) — with monitoring due to narrow therapeutic index
Severe/refractory cases
- Assisted ventilation (non-invasive or invasive mechanical ventilation) if respiratory failure develops
- Continuous monitoring of vitals, blood gases, and peak flow
Avoid: Sedatives (can suppress respiratory drive)
- 1Respiratory System
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