Rosh Emergency Medicine Practice Test 2026 - Free Emergency Medicine Practice Questions and Study Guide

Albuterol is the medication of choice for rapid intervention in cases of severe asthma exacerbation due to its mechanism as a short-acting beta-agonist (SABA). It works quickly to relax bronchial smooth muscle, leading to bronchodilation, which helps relieve acute symptoms such as wheezing, coughing, and shortness of breath. This rapid onset of action allows it to effectively address the airway obstruction that occurs during an asthma attack.

While oxygen administration is important for patients who are hypoxemic, it does not directly treat the underlying bronchospasm associated with asthma. Cromolyn sodium serves as a preventive treatment for asthma and is not effective in acute exacerbations since its action is not rapid. Levalbuterol, although also a SABA and sometimes used as an alternative to albuterol, is not as commonly cited as the first-line agent in acute settings. Therefore, albuterol remains the primary medication for immediate relief during severe asthma exacerbations.