Bronchitis treatment

An economic externality exists whenever the wellbeing of some individual is affected by the economic activities of others without particular attention to the welfare of that individual. For example, smog-related illnesses such as bronchitis and exacerbated cases of childhood asthma have been blamed, to some extent, on the emissions of nitrogen oxides from automobiles and large fossil-fuel-burning power plants. These illnesses have high treatment costs that are not... 

The treatment of acute bronchitis is symptomatic and supportive in nature. Reassurance and antipyretics alone are often sufficient. Bedrest and mild analgesic-antipyretic therapy are often helpful in relieving the associated lethargy, malaise, and fever. Patients should be encouraged to drink fluids to prevent dehydration and possibly decrease the viscosity of respiratory secretions. 

Routine use of antibiotics in the treatment of acute bronchitis is discouraged however, in patients who exhibit persistent fever or respiratory symptomatology for more than 4 to 6 days, the possibility of a concurrent bacterial infection should be suspected. 

The diagnosis of chronic bronchitis is based primarily on clinical assessment and history. By definition, any patient who reports coughing up sputum on most days for at least 3 consecutive months each year for 2 consecutive years suffers from chronic bronchitis. Table 43-1 presents a classification and treatment scheme for chronic bronchitis. 

Classification System for Patients with Chronic Bronchitis and Initial Treatment Options... 

Oral Antibiotics Commonly Used for the Treatment of Acute Respiratory Exacerbations in Chronic Bronchitis... 

Examination of 13 individuals 5 years after they were occupationally exposed to a chlorine dioxide leak revealed sensitivity to respiratory irritants and nasal abnormalities. Delayed deaths occurred in animals after exposure to 15 0-2 00 ppm for less than 1 hour. Rats exposed daily to 10 ppm died after 10-13 days of exposure effects were nasal and ocular discharge and dyspnea autopsy revealed purulent bronchitis. Another study reported that two to four 15-minute exposures to 5 ppm for 1 month did not alter the blood composition or lung histology of rats similar exposures to 10-15 ppm caused bronchitis, bronchiolitis, catarrhal alveolar lesions, and peribronchial infiltration. Lesions healed within 15 days after treatment. Rats and rabbits exposed for 30 days to 5 or 10 ppm (2 hours/day) had localized bronchopneumonia with elevated leukocyte counts slight reversible pulmonary lesions were found after exposures of 2.5ppm for 4-7 hours/day. No adverse reactions were... 

Sulfonamides are historically important but have been largely replaced by other newer antibacterials. They are still used in urinary infections and in the treatment of bronchitis. The danger of crystal formation in the kidneys is circumvented by administering a mixture of sulfonamides. This changes the solubility characteristics but still has an effect on the bacteria. 

Theophylline reduces contractile activity of smooth musculature, widens bronchi and blood vessels, reduces pulmonary vascular resistance, stimulates the respiratory center, and increases the frequency and power of cardiac contractions. It is used for bronchial asthma, preventing attacks, and systematic treatment. Theophylline is also used for symptomatic treatment of bronchospastic syndrome of a different etiology (chronic obstructive pulmonary disease, chronic bronchitis, and pulmonary emphysema). A large number of combined drags are based on theophylline. Synonyms of theophylline are adophyllin, asthmophyllin, theocin, and many others. 

Isoproterenol and phenylephrine bitartrate Treatment of bronchospasm associated with acute and chronic asthma reversible bronchospasm that may be associated with emphysema or chronic bronchitis. 

COPD- Maintenance treatment of bronchospasm associated with COPD (including emphysema and chronic bronchitis). 

COPD- For maintenance treatment of bronchospasm associated with CORD (including chronic bronchitis and emphysema), the usual dosage for adults is 1 powder inhalation (50 meg) twice daily (morning and evening, approximately 12 hours apart). 

Not indicated for relief of asthma that can be controlled by bronchodilators and other nonsteroid medications, in patients who require systemic corticosteroid treatment infrequently, or in the treatment of nonasthmatic bronchitis. 

Bronchospasm (solution and aerosol) Used alone or in combination with other bronchodilators (especially beta-adrenergics) as a bronchodilator for maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. 

Chronic obstructive pulmonary disease (COPD) associated with chronic bronchitis For the twice-daily maintenance treatment of airflow obstruction in patients with COPD associated with chronic bronchitis. Fluticasone propionate/salmeterol 250 meg per 50 meg twice daily is the only approved dosage for the treatment of COPD associated with chronic bronchitis. Fligher doses, including fluticasone propionate/salmeterol 500 meg per 50 meg, are not recommended. 

Chronic bronchitis due to S. pneumoniae Lomefloxacin is not indicated for the empiric treatment of acute bacterial exacerbation of chronic bronchitis when it is probable that S. pneumoniae is a causative pathogen. 

Since 1966, several carbazole alkaloids which are oxygenated at the C-iing were isolated from different natural sources. Glycozoline (86) was the first member of this class of alkaloids and was obtained from the stem bark of G. pentaphylla (95,96). In 1991, glycozoline (86) was also isolated by McChesney and El-Feraly from the roots of C. lansium (23). In Taiwan, the roots of this ornamental tree are used in traditional medicine for the treatment of bronchitis and malaria (23). In 1999, Chakravarty et al. isolated glycozoline (86) from the roots of G. arborea (62). 

Theophilline is also a minor constituent of tea, but is prepared by direct chemical synthesis for medical use. It functions to relax smooth muscle and, therefore, can be used as a bronchodilator in the treatment of asthma and bronchitis. Aminophylline is a derivative of theophilline (theophylline ethylenediamine), which is often used in place of theophilline due to its greater aqueous solubility. 

Levofloxacin (1), the levo-isomer or the (5)-enantiomer of ofloxacin, received FDA approval in 1996 (Fish, 2003 Hurst et al., 2002 Mascaretti, 2003 Norrby, 1999 North et al., 1998). The initial approval covered community-acquired pneumonia, acute bacterial exacerbation of chronic bronchitis, acute maxillary sinusitis, uncomplicated skin and skin structure infections, acute pyelonephritis, and complicated urinary tract infections (North et al., 1998). Four years later, the levofloxacin indication list grew to include community-acquired pneumonia caused by penicillin-resistant Streptococcus pneumoniae. In addition, in 2002, nosocomial (hospital-acquired) pneumonia caused by methicillin-susceptible Staphylococcus aureus, Pseudomonas aeruginosa, Serratia marcescens, Haemophilus influenzae, Kliebsella pneumoniae, and Escherichia coli was added (Hurst et al., 2002). Finally in 2004, LVX was approved as a post-exposure treatment for individuals exposed to Bacillus anthracis, the microbe that causes anthrax, via inhalation (FDA, 2004). 

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