Although adrenergic therapy may be lifesaving in patients with severe acute asthma, attention must also be directed toward reversing underlying inflammation with corticosteroids. Other therapy for acute severe bronchospasm is controversial, although inhalant anticholinergic therapy may have adjunctive benefit. Aminophylline or magnesium sulfate may be indicated in those patients with life-threatening asthma who do not respond to conventional therapy. Chest radiographs are needed in patients who (1) present in extreme distress, (2) need to be hospitalized, or (3) have clinical manifestations of pneumonia or pneumothorax. Antibiotics are not used for acute asthma in the absence of pneumonia.