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Bronchial Asthma

Also known as: asthma · reactive airway disease · wheezing

Chronic airway inflammation with variable, reversible airflow obstruction — wheeze, cough, breathlessness and chest tightness. Inhaled corticosteroids are the cornerstone; never treat with a reliever alone.

Source · Reviewed 2026-08-15 · v1.0— AI-assisted draft — verify against the cited guideline before clinical use.

⚕️ Education only — not medical advice. Verify against the latest official guideline and your local protocol; confirm every drug dose against the cited source before clinical use.

Who gets it

Children and adults; linked to atopy and family history. Triggers include respiratory infections, allergens, exercise, cold air, smoke and air pollution.

Red flags — escalate / refer

Acute severe: can’t complete sentences, RR ≥25, HR ≥110, or PEF 33–50% of best/predicted.
Life-threatening: silent chest, cyanosis, exhaustion, poor respiratory effort, altered consciousness or SpO₂ <92% → emergency, senior/ICU help.
Frequent reliever use or night waking signals poor control → step up + review.

Work-up / diagnosis

1Diagnose from a history of variable respiratory symptoms PLUS demonstrated variable expiratory airflow limitation (spirometry with bronchodilator reversibility, or PEF variability).
2Assess current control and future-risk; identify triggers and comorbidities (rhinitis, GERD).
3Always check inhaler technique and adherence before escalating therapy.

Management — overview

Acute exacerbation: controlled oxygen to target saturation, repeated inhaled SABA (± ipratropium if severe), and early systemic corticosteroids; reassess and escalate (IV magnesium, ICU) if severe/life-threatening.
Chronic (GINA): every patient gets ICS-containing controller therapy — the preferred track uses low-dose ICS-formoterol as both reliever and maintenance; step up/down by control.
Avoid SABA-only treatment — it does not treat the underlying inflammation.
Educate: inhaler technique, a written action plan, trigger avoidance, and smoking cessation.

In-depthFull dosing & advanced protocol

Drug dosing

Salbutamol (short-acting beta-agonist)

Acute relief / exacerbation

Adult dose: Neb 2.5–5 mg (or 4–10 puffs via spacer), repeat as needed
Paediatric: Neb 2.5 mg or 2–6 puffs via spacer, repeat as needed
Route: Inhaled / nebulised

WHOWHO Model List of Essential Medicines (electronic EML) (2025 (24th)) ↗

Inhaled corticosteroid ± formoterol (e.g. budesonide-formoterol)

Controller (and preferred reliever) — GINA

Adult dose: Lowest effective dose for the GINA step; ICS-formoterol as MART where used
Route: Inhaled

OtherGINA — Global Strategy for Asthma Management and Prevention ↗

Prednisolone (systemic corticosteroid)

Moderate–severe exacerbation

Adult dose: 40–50 mg once daily for 5 days
Paediatric: 1–2 mg/kg/day (max 40 mg) for 3–5 days
Route: Oral

WHOWHO Model List of Essential Medicines (electronic EML) (2025 (24th)) ↗

GINA stepwise control & severe asthma

Step therapy up/down by control using the GINA tracks; ICS-formoterol reliever (Track 1) reduces severe exacerbations.
Add-on options for uncontrolled asthma: LAMA, and biologics for severe eosinophilic/allergic phenotypes.
Acute severe: add IV magnesium sulfate; monitor for fatigue/rising CO₂ needing ventilation.

OtherGINA — Global Strategy for Asthma Management and Prevention ↗

References

Guidelines change. If something here is out of date, tell us — we keep these current.

🚩 Report outdated / suggest update

More protocols

Tuberculosis (drug-sensitive) — NTEPInfection by Mycobacterium tuberculosis. India's National TB Elimination Programme (NTEP) provides free diagnosis and treatment; every case must be notified.Community-Acquired PneumoniaAcute lower-respiratory infection acquired outside hospital — fever, cough, sputum and breathlessness with a new infiltrate on chest X-ray. Streptococcus pneumoniae is the commonest cause.Chronic Obstructive Pulmonary Disease (COPD)Chronic, progressive airflow limitation (not fully reversible) from noxious exposures — persistent cough, sputum and breathlessness. Smoking and biomass smoke are the key causes.

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👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Salbutamol (short-acting beta-agonist)

Inhaled corticosteroid ± formoterol (e.g. budesonide-formoterol)

Prednisolone (systemic corticosteroid)

📈 GINA stepwise control & severe asthma

📚 References

More protocols

👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Salbutamol (short-acting beta-agonist)

Inhaled corticosteroid ± formoterol (e.g. budesonide-formoterol)

Prednisolone (systemic corticosteroid)

📈 GINA stepwise control & severe asthma

📚 References

More protocols

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

GINA stepwise control & severe asthma

References

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

GINA stepwise control & severe asthma

References