Table 3.

Pharmacologic management in the emergency department

Agent	Dose
Salbutamol (albuterol)	2.5 mg (0.5 ml) in 2.5 ml normal saline by nebulisation continuously, or every 15–20 min until a significant clinical response is achieved or serious side effects appear
Epinephrine	0.3–0.4 ml of a 1:1000 solution subcutaneously every 20 min for 3 doses
Terbutaline	Preferable to epinephrine in pregnancy
β-agonists	Intravenous administration should be considered in patients who have not responded to inhaled or subcutaneous treatment, in whom respiratory arrest is imminent
Corticosteroids	Methylprednisolone 60–125 mg (intravenous) or prednisone 40 mg (oral)
Anticholinergics	Ipratropium bromide 0.5 mg by nebulisation every 1–4 hours, combined with salbutamol
Methylxanthines	Theophylline 5 mg/kg (intravenous) over 30 min – loading dose in patients not already on theophylline, followed by 0.4 mg/kg/hour intravenous maintenance dose. Serum levels should be checked within 6 hours