Guidelines from the National Asthma Education and Prevention Program (2007) recommend managing mild asthma exacerbations with the addition of a short-acting beta agonist to the treatment regimen, and if response is incomplete, adding an oral corticosteroid. Escalating the dose of long-acting controller medication is not recommended as part of management of the acute exacerbation. This approach has several significant problems:
Oral corticosteroid medications, although effective, have significant toxicity, even in short bursts.
The use of beta agonists relieves asthma symptoms but does not prevent a mild exacerbation from progressing to a severe exacerbation.
Nonadherence to the daily use of long-acting controller medication is extremely common.,