Role of a drug called Montelukast, in acute asthma attack

INTERVENTION: Patients in the treatment arm 1 will receive oral montelukast 10 mg first dose in the ER followed by 10 mg oral dose once a day in evening for the duration of stay in the hospital CONDITION: Acute asthma PRIMARY OUTCOME: Primary Outcome 1:Improvement in FEV1 Primary Outcome 2:Improvement in PEFR SECONDARY OUTCOME: Secondary Outcome 1:Development of complications such as respiratory failure, cardiac arrest and/or death INCLUSION CRITERIA: All adults (age 16 and above), presenting to the ER or clinic of Aga Khan University Hospital (AKUH) with acute asthma exacerbation will be eligible for the study. They will be included if they have one or more features suggestive of ‘Acute asthma exacerbation’ according to GINA Guidelines and are hospitalized Acute asthma exacerbation is characterized by a progressive increase in shortness of breath, cough, wheezing or chest tightness, and by a decrease in expiratory flow that can be quantified by simple measures of pulmonary function such as PEFR and FEV1. The severity of exacerbations may range from mild to life‐threatening. Hospital admission criteria will be standardized: a.FEV1 < 70% predicted or PEFR < 300 L/min after receiving initial treatment in the emergency room b.Respiratory rate > 24 breaths/min c.No improvement in symptoms like shortness of breath or wheezing