Asthma & COPD exacerbation

For healthcare professionals. This information does not replace clinical judgement in the individual case; the current summary of product characteristics and the guidelines cited are authoritative.

Medically reviewed: Dr. med. univ. Daniel Pehböck, DESA, 03.11.2026

Asthma & COPD exacerbation: Asthma attack – severity in adults and adolescents, Asthma attack – severity in children, Oxygen, Asthma attack – treatment in adults, Intubation and ventilation in status asthmaticus, Asthma attack – children – concise for emergency, anaesthesia and intensive care teams, with sources and medically reviewed.

What the chapter covers

1. Asthma attack – severity in adults and adolescents
2. Asthma attack – severity in children
3. Oxygen
4. Asthma attack – treatment in adults
5. Intubation and ventilation in status asthmaticus
6. Asthma attack – children
7. COPD exacerbation
8. Further treatment

Drugs in this chapter

• Salbutamol (albuterol)
• Ipratropium bromide
• Prednisolone
• Methylprednisolone
• Hydrocortisone
• Magnesium sulfate
• Ketamine (racemic)

Sources and guidelines

1. Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention.
2. Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention, Update 2025 (inkl. Korrektur 11/2025: Salbutamol vernebelt für Kinder ≤ 5 J. 2,5 mg). ginasthma.org.
3. Global Initiative for Asthma (GINA). Summary Guide for Asthma Management and Prevention 2024. ginasthma.org.
4. Bundesärztekammer, KBV, AWMF. Nationale VersorgungsLeitlinie Asthma.
5. British Thoracic Society/SIGN. Algorithmus „Management of acute asthma in adults in hospital“ (Right Decisions, NHS Scotland.
6. BTS/NICE/SIGN Asthma-Pathway (SIGN 244), Right Decisions NHS Scotland.
7. Hossny E et al. Management of Asthma in Children 5 Years and Under. World Allergy Organization, Update 2020 (Zusammenfassung nach GINA).
8. Nederlandse Vereniging voor Kindergeneeskunde (NVK). Richtlijn Astma bij kinderen.
9. British Thoracic Society, Scottish Intercollegiate Guidelines Network. SIGN 158.
10. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for the Prevention, Diagnosis and Management of COPD.
11. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for the Diagnosis, Management, and Prevention of COPD.
12. Celli BR, Fabbri LM, Aaron SD et al. An Updated Definition and Severity Classification of Chronic Obstructive Pulmonary Disease Exacerbations: The Rome Proposal. Am J Respir Crit Care Med 2021;204:1251–1258 (von GOLD übernommene Schweregradeinteilung).
13. Bundesärztekammer, KBV, AWMF. Nationale VersorgungsLeitlinie COPD, 2. Auflage.
14. Anthonisen NR, Manfreda J, Warren CP et al. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med 1987;106:196–204 (Kardinalsymptome Dyspnoe, Sputummenge, Sputumpurulenz).
15. Rochwerg B, Brochard L, Elliott MW et al. Official ERS/ATS clinical practice guidelines.
16. Gottlieb J et al. S3-Leitlinie Sauerstoff in der Akuttherapie beim Erwachsenen, AWMF-Register-Nr. 020-021, Stand 06/2021; Kurzversion Pneumologie 2021. Zielbereiche abhängig vom Hyperkapnierisiko.
17. Lott C et al. European Resuscitation Council Guidelines 2025: Special Circumstances in Resuscitation. Resuscitation 2025;215 Suppl 1:110753.
18. Kreislaufstillstand unter besonderen Umständen bei Erwachsenen.
19. Soar J, Böttiger BW et al. European Resuscitation Council Guidelines 2025 Adult Advanced Life Support. Resuscitation 2025;215 Suppl 1:110769 (Korrigendum 2026).
20. Djakow J, Turner NM, Skellett S et al. European Resuscitation Council Guidelines 2025 Paediatric Life Support. Resuscitation 2025;215 Suppl 1:110767.
21. Leatherman J. Mechanical ventilation for severe asthma. Chest 2015;147:1671–1680 (niedrige Atemfrequenz, lange Exspiration, permissive Hyperkapnie, Begrenzung der dynamischen Überblähung)
22. Summaries of product characteristics of authorised products – product and section for each dose in the app.