Introduction: ‘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. Areas covered: The purpose of this review is to discuss current knowledge on the pharmacotherapeutic strategies for treatment of CAS. Expert opinion: 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.

Pharmacotherapeutic strategies for critical asthma syndrome: a look at the state of the art

Maglio A.;Pelaia C.;Pelaia G.;
2020-01-01

Abstract

Introduction: ‘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. Areas covered: The purpose of this review is to discuss current knowledge on the pharmacotherapeutic strategies for treatment of CAS. Expert opinion: 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.
2020
Acute asthma
anticholinergics
asthma exacerbation
asthma therapy
beta 2 agonists
CAS
corticosteroids
critical asthma syndrome
severe asthma
Administration, Inhalation
Adrenal Cortex Hormones
Adrenergic beta-Agonists
Anti-Asthmatic Agents
Asthma
Cholinergic Antagonists
Critical Illness
Humans
Respiration, Artificial
Severity of Illness Index
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.12317/63353
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