Management of Acute Asthma Exacerbations in Urgent Care: An Update (Pharmacology CME)

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Delivery Method:	Online
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Publication Date: June 2026 (Volume 5, Number 6)

CME Credits: 4 AMA PRA Category 1 Credits™, 4 ACEP Category I credits, 4 AAFP Prescribed credits, and 4 AOA Category 2-B CME credits. CME expires 06/01/2029.

Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 1 Pharmacology CME credit, subject to your state and institutional approval.

Authors

Abstract

Asthma is a disease of the airways characterized by inflammation, hyperresponsiveness, and bronchoconstriction. The diagnosis of acute asthma exacerbation is primarily a clinical one, based on a focused history and physical examination. It is important to differentiate it from other entities such as heart failure, pneumonia, and pulmonary embolism, which can present with similar respiratory signs. Urgent care asthma management is focused on rapid stabilization of acute exacerbation, followed by reinforcement and optimization of the patient's asthma management plan to prevent relapse risk and repeat visits. Inhaled corticosteroids are now recommended as part of the at-home treatment for asthma across all severities. This issue reviews the latest evidence in diagnostic and treatment strategies, including other pharmacologic treatments and newer management strategies.

Case Presentations

A 40-year-old man with a history of severe asthma presents to urgent care with wheezing and difficulty breathing...

• He has a history of frequent urgent care visits for asthma, including multiple hospital admissions and intubations.
• The patient is slightly tachypneic and not using accessory muscles to breathe. On auscultation, air entry is significantly diminished bilaterally, and he has faint expiratory wheezing bilaterally.
• His vital signs are: blood pressure, 155/85 mm Hg; heart rate, 120 beats/min; respiratory rate, 20 breaths/min; temperature, 36.9°C; and oxygen saturation, 91% on room air.
• You recognize that this patient needs ED management but consider what interventions are needed while you await transport…

A 20-year-old woman arrives at urgent care with complaints of difficulty breathing and dry cough...

• The patient says she discontinued her asthma medications because she has not used them in the past 2 years.
• Her vital signs are: blood pressure, 120/75 mm Hg; heart rate, 80 beats/min; respiratory rate, 18 breaths/min; and room-air pulse oximeter reading, 97%.
• On auscultation she has faint diffuse wheezing with good air movement.
• You consider the treatment options for this patient…

A 25-year-old man presents to urgent care with an ankle sprain...

• Upon discharge, he asks, "Can you refill my albuterol inhaler?"
• He does not have any respiratory symptoms currently.
• You mentally question if he is on the correct treatment and whether you should refill his inhaler...

Accreditation:

EB Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.