Acute bronchospasm

Occasionally Hie patient may experience an acute bronchospasm either as a result of the disease after exposure to an allergen, or as an adverse reaction to some antiasthma dragp, such as cromolyn inhalation. 

An inhaled sympathomimetic, such as albuterol, may be prescribed initially. Salmeterol, a long-acting (5-agonist, is contraindicated because of its slowed onset of action. During an acute bronchospasm, the nurse checks the blood pressure pulse, respiratory rate, and response to the drug every 15 to 35 minutes until the patient s condition stabilizes and respiratory distress is relieved. 

Acute bronchospasm causes severe respiratory distress and wheezing from the forceful expiration of air and is considered a medical emergency, ft is characterized by severe respiratory distress, dyspnea, forceful expiration, and wheezing. The nurse must report these symptoms to the primary health care provider immediately. 

The nurse may administer epinephrine subcutaneously for an acute bronchospasm. Therapeutic effects occur within 5 minutes after administration and last as long as 4 hours. 

Three years after introduction of aspirin into therapy, Hirschberg in Poznan, now in Poland, described the first case of a transient, acute angioedema/urticaria, occurring shortly after ingestion of aspirin. Reports of anaphylactic reactions to aspirin soon followed. The other major type of adverse reaction, acute bronchospasm, was described in the second decade of the 20th century. In 1920, Van der Veer reported the first death due to aspirin. The association of aspirin sensitivity, asthma and nasal polyps was first recorded by Widal in 1922. This clinical entity, later named the aspirin triad was popularized in 1968 by Samter and Beers [3], who presented a... 

In order to effectively treat respiratory acidosis, the causative process must be identified and treated. If a cause is identified, specific therapy should be started. This may include naloxone for opiate-induced hypoventilation or bronchodilator therapy for acute bronchospasm. Because respiratory acidosis represents ventilatory failure, an increase in... 

Metered dose Inhaler-2 to 3 inhalations every 3 to 4 hours. Do not exceed 12 inhalations/day. Not recommended for children younger than 12 years of age. Inhalant solutions - Usually, treatment need not be repeated more often than every 4 hours to relieve acute bronchospasm attacks. In chronic bronchospastic pulmonary diseases, give 3 to 4 times/day. A single dose of nebulized metaproterenol in the treatment of an acute attack of asthma may not completely abort an attack. Not recommended for children younger than 12 years of age. 

Relief of acute bronchospasm primary treatment of status asthmaticus or other acute episodes of asthma when intensive measures are required hypersensitivity to any ingredient systemic fungal infections persistently positive sputum cultures for Candida albicans. 

Acute bronchospasm Ipratropium HFA inhalation aerosol is not indicated for the initial treatment of acute episodes of bronchospasm where rescue therapy is required for rapid response. 

Prevention of bronchospasm (inhalation solution, aerosol) To prevent acute bronchospasm induced by exercise, toluene diisocyanate, environmental pollutants, and known antigens. 

Prevention of acute bronchospasm nha e 20 mg (1 amp/vial) administered by nebulization shortly before exposure to the precipitating factor. 

Acute bronchospasm Nedocromil is not a bronchodilator and, therefore, should not be used for the reversal of acute bronchospasm, particularly status asthmaticus. Pregnancy Category B. 

Hypersensitivity reactions Aspirin intolerance, manifested by acute bronchospasm, generalized urticaria/angioedema, severe rhinitis, or shock occurs in 4% to 19% of asthmatics. Symptoms occur within 3 hours after ingestion. Have epinephrine 1 1,000 immediately available. 

WARNING Rqx>rts of anaphylaxis 2—24 h after administration, even in previously treated pts Uses Mod-sevCTe asthma in >/=12 y w/ reactivity to an all gen when Sxs inadequately controlled w/ inhaled st oids Action Anti-IgE Ab Dose 150-375 mg SQ q2-4wk (dose/frequency based on SCTum IgE level BW, see package insert) Caution (B, /-] Contra Component aU gy, acute bronchospasm Disp Inj SE Site Rxn, sinusitis, HA, anaphylaxis rqwrted in 3 pts Interactions May X effectiveness OF vaccines and T tox OF hve vaccines may T natalizumab Infxn tox EMS Not for acute asthma, use inhaled J-agonists allergic Rxns are common OD Unlikely to cause hfe-threatening Sxs, exc t for aU gic Rxn... 

Hydrocortisone is a relatively short-acting agent. For replacement therapy in adrenal insufficiency it is administered orally and in combination with fludrocortisone. Hydrocortisone sodium succinate is a water-soluble derivative which can be used parenter-ally in emergencies such as acute bronchospasm and hypersensitivity reactions like anaphylactic shock. 

The medical and scientific communities have recognized that asthma is not simply a disease marked by acute bronchospasm but rather a complex chronic inflammatory disorder of the airways. On the basis of this knowledge, antiinflammatory agents, particularly corticosteroids, are now included in the treatment regimens of an ever-increasing proportion of asthmatic patients. 

Cromolyn sodium and nedocromil sodium are used almost exclusively for the prophylactic treatment of mild to moderate asthma and should not be used for the control of acute bronchospasm. These agents are effective in about 60 to 70% of children and adolescents with asthma. Unfortunately, there is no reliable means to predict which patients will respond. They are less effec-... 

In susceptibie individuais, NSAIDs may precipitate acute bronchospasm. It affects 10-20% of adults with asthma but is rare in asthmatic children. The mechanism is related to cyclooxygenase inhibition, with shunting of arachidonic acid metabolism from the prostaglandin pathway to the biosynthesis of ieukotrienes with increased mucosal permeability and bronchospasm. Susceptible patients should avoid NSAIDs since the bronchospasm may be severe and has been fatal. Paracetamol in doses up to 1000 mg daiiy wiii be toierated by most patients. True type I allergic reactions to NSAIDs, with specific IgE, are rare but anaphyloactoid reactions have occasionally been described in patients with a history of aiiergy or bronchiai asthma. 

Cromolyn, nedocromil Alters function of delayed chloride channels inhibits inflammatory cell activation Prevents acute bronchospasm Asthma (other routes used for ocular, nasal, and gastrointestinal allergy) Aerosol t duration 6-8 h t Toxicity. Cough not absorbed so other toxicities are minimal... 

A small number of individuals exhibit aspirin intolerance or supersensitivity.84 These individuals comprise approximately 1 percent of the general population, but the incidence is considerably higher (10%-25%) in people with asthma or other hypersensitivity reactions.84,94 People with aspirin intolerance will display allergiclike reactions, including acute bronchospasm, urticaria, and severe rhinitis, within a few hours after taking aspirin and aspirinlike NSAIDs.45,76 These reactions may be quite severe, and cardiovascular shock may occur. Likewise, sensitivity to aspirin often indicates a concomitant sensitivity to other NSAIDs, including COX-2 selective drugs.92 Consequently, the use of all NSAIDs is contraindicated in these individuals.84... 

Ephedrine, given im/iv/sc, is indicated for the treatment of acute hypotensive states, treatment of Adams-Stokes syndrome with complete heart block, stimulation of the central nervous system (CNS) to combat narcolepsy and depressive states, treatment of acute bronchospasm, treatment of enuresis, and treatment of myasthenia gravis. When given in nasal form, ephedrine is used in the treatment of nasal congestion, promotion of nasal or sinus drainage, or relief of eustachian tube congestion. 

Aminophylline is used in the treatment of asthma (as a bronchodilator) and in chronic obstructive pulmonary disease. In acute bronchospasm, aminophylline should not be given by the intravenous route the oral route is preferred. Parenteral administration can cause pain and is not recommended. Aminophylline is used as a cosmetic to remove fat from the thigh.45... 

Chronic bronchitis, pneumoconiosis, obstructive lung disease, focal emphysema, progressive massive fibrosis (PMF), coal workers pneumoconiosis (CWP), siUcosis Acute bronchospasm, pneumonitis, chronic exposure leads to Itmg fibrosis, progressive massive fibrosis (PMF), coal workers pneumoconiosis (CWP), silicosis Ocular and upper airway irritation, bronchospasm in severe exposure, contact dermatitis... 

Timolol use can bring on wheezing, dyspnea, bronchospasm, and other signs and symptoms of decreased respiratory function. Acute bronchospasm can occm in previously asymptomatic asthmatic patients after the topical use of timolol.Timolol elicits an average decrease of 25% in forced expiratory volume (FEVl) in patients with chronic obstructive pulmonary disease (COPD) (Figure 107). 

A range of allergic skin reactions, acute anaphylactic shock, acute bronchospasm (in predisposed patients), and cross-sensitivity to aspirin have been reported (14). 

Graham CF. Intravenous verapamil-isotopin (Calan) acute bronchospasm. ADR Highlights 1982 868 82. 

One patient had acute bronchospasm after a subcutaneous injection of GM-CSF around a lower hmb ulcer (25). 

Schreuder G. Ketoprofen possible idiosyncratic acute bronchospasm. Med J Aust 1990 152(6) 332-3. 

Two cases of acute bronchospasm have been reported after the intravenous administration of metoclopramide, one in a patient with pre-existing asthma (SEDA-16,419). 

Status asthmaticus and acute bronchospasm have been linked to the use of metabisulfites (3). 

The major symptoms of an adverse reaction to a sulfite are flushing, acute bronchospasm, and hypotension (SED-11, 492) (SEDA-10, 232) (SEDA-11, 221) (5). The incidence of sulfite sensitivity in an asthmatic population is estimated at about 10%. Sulfites have therefore been withdrawn from the composition of several medicines intended for asthmatic patients. 

Streptokinase can cause acute bronchospasm, sometimes fatal (13), or dyspnea. 

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