Paper I
2020 February (Supplementary) (2010 Scheme) · 40 marks · 120 min

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)

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