Treatment During an Attack


• If the attack is very severe and prolonged, leading todeficiency of oxygen in the blood, which can be clinicallyascertained by looking for bluish tinge on the body, tongueorconjunctivae, then administration of oxygen through noseis called for.

• The narrowing of the airways has to be removed andproduction of excessive secretion stopped.


• If there are signs of infection in the lungs, appropriateantibiotics are to be given.

• If the patient is dehydrated, intravenous 5 per cent glucose-saline is to be given.

Let us take up these items in more detail. Giving of Theophylline tablets, 2 tablets twice or thrice a day, depending upon the age, weight and severity of the condition, proves very helpful. Theophylline-Retard or sustained action tablets are also available.

The simplest and the well-tried drug combination for causing dilatation of the airways is giving a tablet which contains ephedrine, aminophylline and phenobarbitone. This combination is available under different proprietory names such as Tedral, Franal etc. This can be repeated two or three times a day. For children, syrups are available containing this combination.
For most patients having mild or moderate attack of asthma, this proves very helpful and even adequate in itself. Some patients do complain of palpitation after taking these tablets, and older patients having high blood pressure have to take it in lesser quantities. Ephedrine in it can cause constipation and if the patient has some enlargment of the prostate, it can cause some difficulty in passing urine. But generally speaking, such tablets prove very efficacious.

Drugs like salbutamol (which are B-2 stimulators) have come into use lately. They specifically dilate the bronchial airways without excessively stimulating the heart, so that they do not usually lead to palpitation. These drugs come in the form of tablets, injections or aerosol inhalers, hi combination with deriphy Hine, salbutamol tablets prove very useful,
In case there is a severe attack of asthma, deriphylline injection given intramuscularly or aminophylline with 5 per cent glucose intravenously, slowly in 5 to 10 minutes proves helpful. Aminophylline given through intravenous drip with 5 per cent glucose is very useful. An injection of adrenaline(l: 1000 solution) V£ ml, given very slowly subcutaneously, is also effective in many cases.


Most patients usually need only this medication and care. But, at times, the symptoms increase or when an infection supervenes, extra care is needed. If bacterial infection is present in the respiratory passages and unless properly and adequately treated, bronchodilator drugs either exert diminished action or have no action at all, so that the patient keeps getting breathless. So, as far as possible, the causative organism must be identified, its sensitiveness to a drug found, and then the proper drug administered.


But in the majority of the cases, this is not possible either because of the lack of facilities or the procedure takes more time than a patient can afford. In such a situation, ampicillin has been found to be helpful: one or two capsules of 250 mg thrice a day for a week proves adequate; the dose and length of administration depends, however, upon the severity of infection.
If the attack of asthma is such that it is not controlled by the bronchodilator tablets, injections as well as the antibiotics, then the patient can be put on corticosteroids. These can be given as tablets or intramuscularly or in very severe cases, intravenously.