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Life-threatening asthma pharmacology — DipIMC MCQ

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ModeratePre-hospital PharmacologyLife-threatening asthma pharmacologyDipIMC

A 35-year-old woman has severe asthma with poor air entry despite repeated salbutamol and ipratropium. She is tiring, oxygen saturations are 89% and intravenous access is available. What is the most appropriate drug/dose?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Magnesium sulphate 2 g IV over about 20 minutes according to local protocol

Intravenous magnesium sulphate may be used in severe or life-threatening asthma that is not responding adequately to initial bronchodilators and oxygen, within local scope. Adenosine, aspirin, naloxone and furosemide do not treat bronchospasm. Magnesium is an adjunct, not a reason to delay escalation for ventilatory failure. The pearl is that silent chest and fatigue are late, dangerous asthma signs.

Reference: JRCALC Guidelines 2025; BTS/SIGN Asthma Guidance