Why are systemic corticosteroids given early in acute asthma management?

• A. They reduce airway inflammation and prevent late-phase bronchoconstriction
• B. They provide immediate bronchodilation
• C. They rapidly improve oxygen saturation within minutes
• D. They dissolve mucus plugs

Answer: (A)

Early systemic corticosteroids are given because they dampen the inflammatory process in the airways and prevent the late-phase bronchoconstriction that follows the initial attack. They work by reducing inflammatory mediators and immune cell recruitment, which lowers edema, mucus production, and airway hyperresponsiveness. This inflammatory control doesn’t provide immediate relief from bronchospasm, so they’re used alongside fast-acting bronchodilators rather than for instant bronchodilation. The clinical benefit appears over hours to a day or so, helping shorten the attack and reduce relapse risk after discharge. They don’t rapidly improve oxygen saturation within minutes, nor do they dissolve mucus plugs—that effect comes from bronchodilators, oxygen therapy, and supportive care.