Pharmacotherapeutic strategies for critical asthma syndrome: a look at the state of the art
- 27 May 2020
- journal article
- review article
- Published by Taylor & Francis Ltd in Expert Opinion on Pharmacotherapy
- Vol. 21 (12), 1505-1515
- https://doi.org/10.1080/14656566.2020.1766023
Abstract
‘Critical Asthma Syndrome’ (CAS) is an umbrella term proposed to include several forms of asthma, responsible for acute and life-threatening exacerbations. CAS requires urgent and adequate supportive and pharmacological treatments to prevent serious outcomes. The purpose of this review is to discuss current knowledge on the pharmacotherapeutic strategies for treatment of CAS. Airflow limitation, airway wall edema, and mucus plugs are the pathophysiological targets of pharmacological therapies. Strategies to achieve these goals are based on the use of various classes of drugs. Inhaled beta2-agonists are the mainstay of the initial therapy of CAS. Inhaled anticholinergic agents may be considered in the treatment of CAS in addition to beta 2 agonists. Systemic corticosteroids should be administered as soon as possible in order to counteract airway inflammation and restore normal airway sensitivity. The effectiveness of pharmacological therapies in CAS is linked not only to the timely use of drugsbut also to the dosage and route of administration. Early recognition and aggressive treatment are essential for the management of CAS; however, prevention is the best cure. Although significant progress has been made, further efforts are needed to implement an optimal exacerbation prevention strategy.Keywords
This publication has 98 references indexed in Scilit:
- A cohort evaluation on arterial stiffness and hypertensive disorders in pregnancyBMC Pregnancy and Childbirth, 2012
- Relationship between Serum Vitamin D, Disease Severity, and Airway Remodeling in Children with AsthmaAmerican Journal of Respiratory and Critical Care Medicine, 2011
- Biochemical Basis of Asthma TherapyPublished by Elsevier BV ,2011
- Glucocorticosteroids: current and future directionsBritish Journal of Pharmacology, 2010
- Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*Allergy, 2008
- Pathological features and inhaled corticosteroid response of eosinophilic and non-eosinophilic asthmaThorax, 2007
- Innate immune activation in neutrophilic asthma and bronchiectasisThorax, 2007
- Mortality in Patients Hospitalized for Asthma Exacerbations in the United StatesAmerican Journal of Respiratory and Critical Care Medicine, 2006
- Randomized, Double-Blind, Placebo-Controlled Trial of Intravenous Ketamine in Acute AsthmaAnnals of Emergency Medicine, 1996
- The use of ketamine for the emergency intubation of patients with status asthmaticusAnnals of Emergency Medicine, 1987