In an acute asthma exacerbation, what is the first-line fast-acting bronchodilator therapy?

• A. Inhaled short-acting beta-agonist (albuterol)
• B. Systemic corticosteroids
• C. Inhaled corticosteroids
• D. Long-acting beta-agonist

Answer: (A)

During an acute asthma flare the goal is to rapidly reverse bronchoconstriction. Inhaled short-acting beta-agonists, such as albuterol, act quickly on beta-2 receptors in the airway smooth muscle, causing rapid dilation of the airways. This immediate bronchodilation reduces airway resistance within minutes and provides fast relief of symptoms, which is why it is the first-line treatment for quick relief in an acute attack.

Systemic corticosteroids, while important for reducing inflammation, take hours to become effective and are not used for immediate relief. Inhaled corticosteroids and long-acting beta-agonists are meant for long-term control and maintenance, not for rapid reversal of an acute episode.