Identify the drugs used in the treatment of an acute asthma attack?

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BlackTom AI · Accepted Answer

The question asks which drugs are used in the treatment of an acute asthma attack. The provided answer describes several drug classes and supportive measures that are commonly employed in acute management, each with a distinct role in relieving bronchospasm, reducing inflammation, or supporting respiration.

First, consider the bronchodilators: β-agonists (SABAs) such as albuterol (salbutamol) and levalbuterol are described as the first-line rapid-relief medications. They act quickly to relax airway smooth muscle, opening the airways within minutes and thereby improving airflow during an acute attack. This aligns with standard practice, where SABAs are the principal fast-acting treatment to alleviate bronchospasm.

Next, anticholinergics: ipratropium bromide is noted as commonly used in combination with SABAs in more severe cases. Anticholinergics work by blocking muscarinic receptors, reducing bronchial secretions and bronchoconstriction, and they can provide additive relief when added to a SABA for severe exacerbations. This reflects their role as an adjunct rather than a standalone first-line agent.

Systemic corticosteroids are listed as prednisone, prednisolone, and methylprednisolone. These do not provide immediate bronchodilation but are crucial for decreasing airway inflammation and preventing progression of the attack. They shorten the duration and severity of the episode and are typically given early in the course, especially if the attack is moderate to severe or not rapidly resolving.

Oxygen therapy is described as indicated in severe hypoxemia to normalize oxygen saturation. Oxygen is not a bronchodilator, but maintaining adequate oxygenation is essential during an acute attack, particularly if airflow limitation is causing hypoxemia. This makes it a supportive but essential component of management.

For more severe cases, the text mentions magnesium sulfate as an option for bronchodilation and noninvasive ventilation (NIV) in the appropriate setting. Intravenous or nebulized magnesium sulfate can provide additional bronchodilation in refractory cases by promoting smooth muscle relaxation. NIV is employed when there is respiratory failure or fatigue, to support ventilation without intubation.

With respect to the items listed: 
- β agonists (SABAs): correct as first-line rapid-relief therapy. 
- Anticholinergics (ipratropium): correct as an adjunct in more severe attacks. 
- Systemic corticosteroids (prednisone, prednisolone, methylprednisolone): correct for anti-inflammatory effect, not immediate relief but essential for preventing deterioration. 
- Oxygen therapy: correct as supportive therapy for hypoxemia. 
- Magnesium sulfate and noninvasive ventilation: correct for more severe or refractory cases where standard therapy is insufficient or there is impending respiratory failure.

In terms of potential misconceptions: 
- One might assume all listed drugs provide immediate relief, but corticosteroids do not; their benefit is in inflammation reduction over hours to days, not minutes. 
- Oxygen therapy is vital when needed, but it does not treat bronchospasm itself; it supports gas exchange. 
- NIV and magnesium sulfate are not for every attack but reserved for severe or deteriorating cases.

Overall, the described list encompasses the core pharmacologic strategies and supportive measures used in acute asthma management, reflecting a stepwise approach from rapid bronchodilation to anti-inflammatory control and supportive care.

2025-HS1-NUR20007-Pharmacology and Pathophysiology in Nursing-H1 M2: Self-Assessment Quiz

Identify the drugs used in the treatment of an acute asthma attack?

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