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Moderate acute asthma in general practice

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

moderate acute asthma in general practice

On assessment:

  • PEF >50–75% best or predicted
  • SpO2 ≥92%
  • speech normal
  • has a pulse rate of <110 beats/min
  • respiratory rate <25 breaths/min


  • patients can be managed at home or in surgery
  • assess response to treatment.


  • β2 bronchodilator:
    • via spacer (give 4 puffs initially and give a further 2 puffs every 2 minutes according to response up to maximum of 10 puffs)
  • if PEF >50–75% predicted/best:
    • nebuliser (preferably oxygen driven) (salbutamol 5 mg)
    • give prednisolone 40–50 mg
    • continue or increase usual treatment

If good response to first treatment (symptoms improved, respiration and pulse settling and PEF >50%) continue or increase usual treatment and continue prednisolone.

Admit to hospital if any:

  • life threatening features
  • features of acute severe asthma present after initial treatment
  • previous near fatal asthma

Lower threshold for admission if afternoon or evening attack, recent nocturnal symptoms or hospital admission, previous severe attacks, patient unable to assess own condition, or concern over social circumstances


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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.


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