Bronchospasm, treatment

Metaproterenol For bronchial asthma and reversible bronchospasm treatment of acute asthmatic attacks in children 6 years of age and older (5% solution for inhalation only). 

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. 

Monitoring and Managing Adverse Drug Reactions Treatment of minor hypersensitivity reactions may include administration of an antihistamine such as Benadryl (for a rash or itching). Major hypersensitivity reactions, such as bronchospasm, laryngospasm,... 

Treatment or prevention of bronchospasm in adults and adolescents 12 years and older with reversible obstructive airway disease... 

Bronchospasm may occur after administration of the inhaled corticosteroids If an immediate increase in wheezing indicating bronchospasm occurs after administration of a corticosteroid inhalant, the nurse immediately administers a shortacting inhaled bronchoditator. The inhaled corticosteroid is discontinued and an alternate treatment started. 

Airway clearance therapy is usually accompanied by bron-chodilator treatment [albuterol (also known as salbutamol outside the United States) by nebulizer or metered-dose inhaler] to stimulate mucociliary clearance and prevent bronchospasm associated with other inhaled agents. A mucolytic agent may be administered to reduce sputum viscosity and enhance clearance. 

Albuterol and other inhaled short-acting selective / -agonists are indicated for treatment of intermittent episodes of bronchospasm and are the first treatment of choice for acute severe asthma and EIB. Regular treatment (four times daily) does not improve symptom control over as-needed use. 

Tlotropium bromide (54 Spiriva Boehringer-Ingelheim/Pfizer, 2004) has been approved by the US Eood and Drug Administration (EDA) for the treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD). Tiotropium, a derivative of atropine from Atropa belladonna (Solanaceae), is a potent reversible nonselective inhibitor of... 

In a field as complex as that involving the treatment of asthma it is not surprising that the initial published clinical work [359] should have come in for more than the usual criticism and controversy. This reception is perhaps even more understandable in view of the fact that the trial material contained isoprenaline (to abolish non-specific bronchospasm due to the dry powder itself), that the... 

In instituting single-drug therapy (monotherapy), the following considerations apply 3-blockers (p. 92) are of value in the treatment of juvenile hypertension with tachycardia and high cardiac output however, in patients disposed to bronchospasm, even 3i-se-lective blockers are contraindicated. 

Dexamethasone Testing of adrenal cortical hyperfunction cerebral edema associated with primary or metastatic brain tumor, craniotomy, or head injury. Tnamc/no/one Treatment of pulmonary emphysema where bronchospasm or bronchial edema plays a significant role, and diffuse interstitial pulmonary fibrosis (Hamman-Rich syndrome) in conjunction with diuretic agents to induce a diuresis in refractory CHF and in cirrhosis of the liver with refractory ascites and for postoperative dental inflammatory reactions. 

Propranolol, nadolol, timolol, penbutolol, carteolol, sotalol, and pindolol Bronchial asthma or bronchospasm, including severe chronic obstructive pulmonary disease. Metoprolol Treatment of Ml in patients with a heart rate less than 45 beats/min significant heart block greater than first degree (PR interval 0.24 seconds or more) systolic blood pressure less than 100 mm Hg moderate to severe cardiac failure. Sotalol Congenital or acquired long QT syndromes. 

Bitolterol Prophylaxis and treatment of bronchial asthma and reversible bronchospasm. May be used with or without concurrent theophylline or steroid therapy. 

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). 

Inhalation aerosol - Start treatment at the first symptoms of bronchospasm. Individualize dosage. 

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. 

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). 

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. 

Asthmatics Carefully observe asthmatics under treatment with acetylcysteine. If bronchospasm progresses, discontinue medication immediately. 

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. 

Aerosol - Several serious adverse events occurred in severely ill infants with life-threatening underlying diseases, many of whom required assisted ventilation. Additional reports of worsening of respiratory status, bronchospasm, pulmonary edema, hypoventilation, cyanosis, dyspnea, bacterial pneumonia, pneumothorax, apnea, atelectasis, and ventilator dependence have occurred. Sudden deterioration of respiratory function has been associated with initiation of aerosolized ribavirin use in infants. If ribavirin aerosol treatment produces sudden deterioration of respiratory function, stop treatment and reinstitute only with extreme caution, continuous monitoring, and consideration of coadministration of bronchodilators. 

In patients who have neither hypotension nor respiratory effects, hydrocortisone and chlorphenamine usually suffice. Supportive treatment with oxygen by face-mask, and intravenous fluid for hypotension, may be helpful. Patients who have predominant or recurrent bronchospasm can receive inhaled... 

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