Development and internal validation of a pediatric acute asthma prediction rule for hospitalization

The aim of this review is to cover the pharmacological treatment of acute asthma with special emphasis on nebulized treatment. Inhaled β₂-agonists is the first-line treatment of acute asthma. There is some evidence that the addition of inhaled anticholinergics to β₂-agonists improves the effect of acute asthma treatment. Treatment with corticosteroids is part of the first-line treatment. Further studies are needed to evaluate whether inhaled steroid treatment can replace systemically administered treatment and thereby reduce the risk of side-effects. At present there is little evidence that inhalation of other drugs such as epinephrine, magnesium or furosemide has any place in the treatment of acute asthma. In most studies the inhaled treatment has been given via a nebulizer, but treatment with a metered-dose inhaler via a spacer appears to be as effective. In children, frequent nebulizations with low doses or continuous nebulization may be more effective than giving the same total dose as high-dose nebulizations, but this has not yet been confirmed in adults.