What is the first-line treatment for acute asthma exacerbation?

The first-line treatment for acute asthma exacerbation is the use of short-acting beta-agonists (SABAs), such as albuterol. SABAs work by quickly relaxing the bronchial smooth muscle, leading to bronchodilation. This action helps to alleviate symptoms of acute asthma such as wheezing, shortness of breath, and chest tightness, making them an essential component of acute asthma management.

These medications are preferred in an acute setting because they start to take effect rapidly, usually within minutes, allowing for quick relief of symptoms. This rapid action is vital during an exacerbation when a patient may be experiencing significant respiratory distress.

While systemic corticosteroids can be beneficial for longer-term management and to reduce inflammation during an exacerbation, they are not the immediate go-to treatment because they take longer to exert their effects. Long-acting beta-agonists (LABAs) are not suitable for acute attacks as they require a longer time for onset and are not indicated for rescue use. Anticholinergics can provide additional benefits but are generally used as adjunctive therapy rather than as the primary treatment for acute exacerbations. Thus, the immediate need for bronchodilation makes SABAs the cornerstone of acute asthma treatment.