What is the recommended approach to manage an adrenaline-resistant severe asthma attack?

In the management of an adrenaline-resistant severe asthma attack, utilizing magnesium sulfate is an important strategy. Magnesium sulfate acts as a bronchodilator, which can help relieve bronchospasm by relaxing the smooth muscles in the airways. Its mechanism is distinct from that of catecholamines like adrenaline, which might be insufficient in particular cases of severe asthma exacerbation.

When conventional treatments, such as beta-agonists and corticosteroids, are not effectively managing the asthma attack, magnesium sulfate can provide an additional benefit. It enhances airway diameter and reduces airway inflammation, improving oxygenation. This is especially useful in life-threatening situations where rapid bronchodilation is necessary.

While increasing oral steroid dosage may help in reducing inflammation over time, it does not provide immediate relief during an acute attack. Administering additional anticholinergics may offer some bronchodilation but is typically used as an adjunct to beta-agonists rather than as a standalone treatment in severe cases. Using ketamine for sedation could potentially compromise respiratory drive in a patient already struggling to breathe, and it does not directly address bronchospasm or airway inflammation.

Thus, among the options presented, the use of magnesium sulfate stands out as the recommended approach for its immediate therapeutic effects in cases where conventional