Asthma Medicines

An asthmatic attack is one of the most striking medical emergencies. One of my first experiences with severe asthma was in the intensive care unit of Bellevue Hospital. I had been called to consult on a fifty-six-year-old woman who was having a severe asthmatic attack. As I entered the unit and approached the bedside, I noted several physicians already in attendance. The patient was sitting upright with labored breathing and I could hear her wheezing from several feet away. It was clear that she was not doing well despite continuous oxygen and medicated aerosol treatment. Unable to speak due to shortness of breath, her expression was one of fear and desperation. Several days later, greatly improved after vigorous treatment, I asked her to describe what she had been feeling during her attack. “It was like I was drowning.”

In the asthmatic attack there is constriction or tightening of the bronchial wall muscle, and secretion of mucus, often with “plugging” of small air tubes, as well as inflammation and swelling of the bronchial lining. The end result is blockage or obstruction of the bronchial tubes. The frequency, duration, and severity of the asthmatic attack varies markedly from patient to patient.

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