TY - JOUR T1 - Salbutamol or aminophylline for acute severe asthma: how to choose which one, when and why? JF - Archives of disease in childhood - Education & practice edition JO - Arch Dis Child Educ Pract Ed SP - 215 LP - 222 DO - 10.1136/archdischild-2014-306186 VL - 100 IS - 4 AU - Matthew Neame AU - Octavio Aragon AU - Ricardo M Fernandes AU - Ian Sinha Y1 - 2015/08/01 UR - http://ep.bmj.com/content/100/4/215.abstract N2 - Acute, severe exacerbations of asthma present a challenge due to the significant morbidity associated with this presentation. For exacerbations that are refractory to initial treatments with inhaled and oral therapies, there is still doubt about which intravenous therapies are most likely to be helpful. β-2 agonists and aminophylline have differing mechanisms of action that also affect their adverse effects profiles and these are considered. A review of the available randomised control trials suggests that a bolus of intravenous salbutamol may reduce symptoms and hasten recovery. Aminophylline infusions may improve lung function, and in some studies have been shown to improve symptoms, but the evidence is not clear cut. Decisions about which treatment to use should include risk management considerations such as ease of prescription, preparation and administration factors and availability of high-dependency beds. ER -