Acute care of mild to moderately severe asthma in 1990.

When considering the acute treatment of mild to moderately severe asthma in the outpatient or emergency room setting, the author indicates how older, effective modalities of care can be replaced with modalities which are at least as effective but also teach the patient how to care for himself. Older approaches including epinephrine injections, intravenous aminophylline, intravenous superhydration, nebulizer-generated aerosols, and oxygen have the disadvantage of binding the patient to the emergency room for future attacks. By stressing proper use of sympathomimetic metered-dose inhalers (often with a spacer), oral theophyllines, oral B-2 agonists, oral and inhaled corticosteroids, the 90% of patients well enough to go home after treatment will have had a lasting educational experience designed to increase their self-reliance and make further ER visits unnecessary.