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Last Updated on February 10, 2023


A chronic respiratory condition called Asthma results in inflammation and airway narrowing. An Asthma exacerbation occurs when a person’s Asthma gets worse or develops new symptoms. Exacerbations, also known as Asthma Attacks, can sometimes occur suddenly.

The airways swell and inflame during an Asthma attack. The breathing tubes (bronchial tubes) narrow as a result of the muscles surrounding the airways contracting and producing extra mucus. During an attack, you may cough, wheeze and have trouble breathing. Symptoms of a minor Asthma attack get better with prompt treatment. A severe Asthma attack that doesn’t improve with treatment can become a life-threatening emergency.

Early diagnosis and treatment of an Asthma flare-up are essential to prevent an Asthma attack. Your treatment plan should outline what to do if your Asthma worsens and how to handle an Asthma attack that is already underway. There are multiple Asthma Clinical Trials in Michigan that may be able to help people with their symptoms. The goal of Clinical Trials is to introduce new and effective treatments that may be able to help people living with Asthma.

Asthma Exacerbation:

People with severe Asthma frequently experience Asthma exacerbations, which typically have a trigger. The most frequent causes of Asthma attacks in both adults and children are viral respiratory infections, like human rhinovirus subtypes A and C. However, a person’s risk of developing an Asthma attack is not always increased by having a respiratory infection.

Exacerbations of Asthma may also be brought on by:

  • bacterial illnesses
  • allergies weakened antiviral defense
  • pollutants that cause allergic reactions, such as tobacco smoke and particulate matter exposures in the workplace

An individual can manage their symptoms and seek immediate assistance when necessary with the aid of ongoing medical care and an Asthma treatment plan.

Symptoms of Asthma Exacerbation:

An Asthma exacerbation includes the following signs:

  • Difficulty breathing
  • Rapid heartbeat, coughing, wheezing, or gasping, and rapid breathing
  • Panic and anxiety attacks
  • A severe Asthma attack can cause a person to lose consciousness, become disoriented, or have their hands and feet turn blue or white.

If a person is unable to breathe for an extended period due to an Asthma attack that is not treated, they may die or suffer permanent bodily harm. But this is uncommon.

Some people start to exhibit warning signs of an impending Asthma attack one or two days beforehand. A person may be able to anticipate their next attack by keeping a record of these symptoms. Typical indicators of an impending attack include:

  • An undiagnosed cough, difficulty breathing, a scratchy or sore throat, poor sleep, increased chest congestion, and exhaustion
  • A headache, stomachache, fever, or chills
  • A flare-up of eczema aggravated allergy symptoms
  • Itchy or watery eyes
  • A stuffy or runny nose

Pathophysiology of Asthma:

When exposed to specific triggers, an overly sensitive immune system causes your airways (bronchial tubes) to swell up and be inflamed. Each individual has different Asthma triggers.

pathophysiology of asthma

Common causes of Asthma exacerbation include:

  • Pets, mold, pollen, and dust mites
  • Upper respiratory illnesses
  • Cigarette smoke
  • Breathing in brisk, dry air
  • Gastroesophageal Reflux (GERD)
  • Stress

Many people find that respiratory infections like the common cold worsen their Asthma symptoms. Some people experience Asthma flare-ups as a result of something at work. Sometimes an Asthma exacerbation appears to have no apparent cause.

Causes of Asthma Exacerbation:

An Asthma exacerbation might seem to strike out of the blue. But a lot of people discover that certain triggers lead to their attacks. One can prevent their next attack by keeping a log of these triggers.

Typical triggers include:

  • Weather changes
  • Allergens like pollen, molds
  • Sinus infections, and other respiratory conditions
  • High levels of physical activity
  • Exposure to pet dander
  • Cleaning agents
  • Fragrances, or other chemicals
  • Indoor air pollution
  • Stress or illnesses

An Asthma exacerbation could be more likely to be severe if:

  • You’ve had a severe Asthma episode in the past
  • You’ve experienced Asthma-related hospital admissions or ER visits in the past
  • You’ve previously required intubation for an Asthma episode
  • You use more than two quick-acting (rescue) inhalers a month
  • Your Asthma episodes tend to sneak up on you before you notice symptoms have worsened
  • You have other chronic health conditions, such as sinusitis or nasal polyps, or cardiovascular or chronic lung disease


You’ll probably be able to identify the symptoms if you’ve ever experienced an asthma exacerbation. You will have an immediate diagnosis from your doctor.

Your doctor will need to know your medical history, especially if this is your first acute exacerbation. Your doctor will likely conduct a physical examination and a lung function test to properly diagnose you.

To determine how well your lungs are functioning, you might undergo one of the following tests:

Maximum Flow Test:

A peak flow test that quantifies your exhalation rate. You blow as forcefully as you can into a mouthpiece to obtain a reading. Peak flow meters can be used at home as well.


spirometry test

A spirometer might also be used by your doctor. Your ability to breathe in and out quickly can be measured by this device. It impacts how much air your lungs can hold as well. You must breathe into a special hose that is attached to a meter to obtain these readings.

Test for Nitric Oxide:

To perform this test, you must breathe into a mouthpiece that detects the level of nitric oxide in your breath. Your bronchial tubes are inflamed if the level is high.

Measures of Blood Oxygen Levels:

Checking your blood’s oxygen content might be necessary if you’re having a severe asthma episode. A pulse oximeter can be used to perform this. A small device called a pulse oximeter is attached to the tip of your finger. The test can be completed at home and only takes a few seconds.


An Asthma exacerbation can be serious. It can:

  • Disrupt routine activities like sleep, study, work, and exercise, which disrupt your quality of life and may affect those around you.
  • Send you to the ER, which can be expensive and stressful.
  • Leading to respiratory arrest and death.

The Right Time to Seek Emergency Medical Care:

If you experience any of the following warning signs or symptoms of a serious Asthma exacerbation, seek medical attention right away.

  • Severe wheezing or breathlessness, especially at night or in the morning
  • Being unable to speak for more than a few words at a time due to shortness of breath
  • Having to breathe with your chest muscles working hard
  • Peak flow meters that give inaccurate readings when used
  • After using a rescue (quick-acting) inhaler, there was no improvement.

Prevention of Asthma Exacerbation:

Prevention of asthma

The best way to avoid an Asthma exacerbation is to make sure your Asthma is well controlled in the first place. This involves tracking your symptoms and adjusting your medication according to a written Asthma treatment plan.

While you may be unable to eliminate your risk of an Asthma episode, you’re less likely to have one if your current treatment controls your Asthma. As guided in your detailed Asthma action plan, take your inhaled medications.

The airway inflammation that results in Asthma symptoms and signs is treated by these preventative medications. When taken regularly, these drugs can lessen or completely stop Asthma attacks and the requirement for quick-acting inhalers.

If you are complying with your Asthma action plan but continue to experience frequent or bothersome symptoms or have low peak flow readings, consult your doctor. These are indications that your Asthma is not under control, and you should work with your doctor to modify your medication.

If your asthma symptoms flare up when you have a cold or the flu, take steps to avoid an Asthma exacerbation by watching your lung function and symptoms and adjusting your treatment as needed. When exercising outside in cold weather, make sure to wear a face mask and minimize your exposure to allergy triggers.

Management of Asthma Exacerbation:

Drugs for Asthma typically fall into one of three categories. It’s likely that you regularly take medications to ward off attacks. Quick-relief asthma medications are another option. Asthma attacks are treated by these drugs, but preventing attacks also requires taking them as soon as symptoms appear. Medication for Asthma may be in the form of a tablet, an inhaler, a nebulizer, or a shot.

asthma exacerbation treatment

The following are a few of the popular preventive medicines for Asthma exacerbation:

Inhaled Corticosteroids:

These suppress inflammation by functioning like natural hormones. Although steroids are the most effective medications for treating Asthma, their long-term side effects make them less suitable for routine use.

Leukotriene modifiers:

These drugs function by preventing the production of leukotrienes, which white blood cells discharge. The inflammation process involves leukotrienes.


By calming the muscles that regulate the airways, beta-agonists can both prevent and treat Asthma attacks. You are now able to breathe more easily. Other names for them include bronchodilators.

However, there are several ways to lower the chances of an Asthma episode. They consist of:

  • Exercising
  • Preserving or achieving a healthy body weight
  • Avoiding the causes of Asthma
  • Controlling dietary and environmental allergies
  • Taking certain medications, such as maintenance inhalers and potential biologic therapy, when quitting smoking

The following interventions may be beneficial for some people.

Help the person maintain their calm:

Because panic can make it harder to breathe.

Get away from the trigger or allergen:

For many people, moving to a cooler, the better-ventilated environment is helpful.

Use a rescue inhaler:

This help reduces the attack’s intensity. Inhalers contain bronchodilators. Observe the dosage schedule specified in the Asthma action plan. Take a few puffs typically every few minutes to hours to accomplish this.

Avoid breathing too quickly:

Sit up straight and inhale deeply and slowly. A person may require oxygen through a mask during a serious Asthma attack. They might need to use a ventilator in the hospital in exceptional circumstances.

People who have Asthma should be in touch with their doctors to develop an attack strategy. This strategy may aid in identifying treatment options and assist a person in maintaining calm during an Asthma attack.

Asthmatics should inform others of their condition. Parents must inform educators about their child’s Asthma and teach them how to follow the Asthma treatment plan.


If any of the following holds, a person is applying treatment effectively:

  • Less than 1 to 2 nights per month they might experience coughing and breathlessness, they need quick-relief medications, they are maintaining good lung function, and their activity levels are remaining normal. Less than 1 to 2 nights per month that they wake up from sleep, they do not require emergency medical treatment, and they have one or fewer Asthma attacks per year that require corticosteroid treatment.
  • Peak flow continues to exceed 80% of the best-ever performance.
  • To maintain good control, people must also avoid allergens and Asthma triggers.

Make an Asthma Treatment Action Plan:

Working on an Asthma treatment plan with your doctor is beneficial. Taking action when you see indications of an exacerbation is also crucial.

Your strategy must incorporate:

  • A list of the potential catalysts for an attack
  • Ways to spot an attack
  • Your medication, dosage, and instructions for use
  • When to seek medical attention if your symptoms worsen and how to adjust your medication
  • Emergency contacts

Bottom Line:

Asthma exacerbation involves gradually worsening Asthma symptoms, such as coughing, wheezing, and breathlessness. Exacerbations of Asthma are frequently attributed to viral respiratory infections.

A doctor should cooperate with the patient to develop an Asthma Treatment Plan after diagnosis of Asthma. These plans describe the warning signs and symptoms of an Asthma episode, making it easier for the sufferer to identify an attack and know what to do.

Exacerbations of Asthma can be very bad, especially in people already at high risk. However, a good Asthma action plan streamlines the care that a person requires when they have an exacerbation. Multiple Clinical Research in Michigan is underway to help introduce an effective treatment plan for those suffering from lung function decline due to Asthma.

Dr. Anusia Thourani

Dr. Anusia is a Dentist and currently working as a Recruitment Associate at Revive Research Institute. Her cheerful personality and enthusiasm for her work in this organization make her a great part of our team.

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Southfield, MI

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