Abstract
Asthma is a common respiratory disorder, and the presentation of patients with acute, poorly controlled asthma remains a clinical challenge. In current guidelines, severe asthma represents a subset of difficult-to-treat asthma that, despite treatment of contributing factors and patient compliance with optimized therapy, remains uncontrolled, or asthma that worsens when high-intensity therapy is decreased. Acute exacerbations are managed with inhaled bronchodilators, inhaled corticosteroids, and oral corticosteroids. Patient-specific pharmacotherapy to prevent acute exacerbations includes the use of inhaled corticosteroids plus a long-acting bronchodilator, a short-acting bronchodilator for rescue, a long-acting muscarinic, a leukotriene antagonist, and biologics.