In the management of an acute asthma attack, which medication should be used first?

• A. Ipratropium
• B. Montelukast
• C. Albuterol (beta 2 adrenergic agonist)
• D. Glucocorticoid

Answer: (C)

In an acute asthma attack, the immediate goal is rapid relief of bronchoconstriction to improve airflow and oxygenation. A fast-acting beta-2 agonist like albuterol delivers that quick relief by relaxing airway smooth muscle and opening the airways within minutes, which directly reduces airway resistance and improves ventilation right away. Other options don’t provide this rapid effect: montelukast helps with inflammation but needs days to work and isn’t for immediate relief; glucocorticoids reduce inflammation over hours to days and aren’t the fist move to stop an acute obstruction; ipratropium can be useful as an add-on in severe cases, but it does not replace the rapid bronchodilation achieved by albuterol. So the first medication to use is albuterol to open the airways quickly.