Spasms pharyngeal

Nasal vasculature may offer some insight into this question, though research to date has been equivocal. Nasal turbinate vessels can be classified as either capacitance vessels or resistive vessels. Capacitance vessels appear to vasodilate in response to infection while resistance vessels appear to respond to cold stimuli by vasoconstriction. Buccal vascular structures also respond to thermal stimuli but appear to respond principally to cutaneous stimuli. How pharyngeal and tracheobronchial submucosal vessels react to thermal stimuli is not known, though cold-induced asthma is believed to result from broncho-spasms caused by susceptible bronchial smooth muscle responding to exposure to cold dry air.- This asthmatic response suggests an inadequate vascular response to surface cooling. 

A 26-year-old woman with schizophrenia who had taken risperidone 6 mg/day for 3 months was found unconscious. She later reported having taken 30 mg of risperidone in a suicidal attempt. On day 3 she developed transient respiratory distress, with lethargy, tongue protrusion, and pharyngeal-laryngeal muscle spasm. 

Involuntary muscle spasm blepharospasm, hemifacial spasm, spasmodic torticollis, and indeed the spasm of chronic anal fissure, are treated with botulinum toxin. This irreversibly blocks release of acetylcholine from cholinergic nerve endings and is injected locally. Its effect lasts about 3 months. Botulinum toxin is at least partially effective in up to 90% of patients with these conditions. Mild dysphagia occurs in 30% of patients receiving injections into their neck for torticoUis due to spread of the toxin in to the pharyngeal muscles. 

Ck)ugh, nausea, pharyngitis, rhinitis, vomiting, dyspepsia, chest pain, headache, broncho spasm... 

D. Not recommended for children under 3 years by manufacturer alternately, use diphenhydramine (see p 436) or consider benztropine if the patient is unresponsive or hypersensitive to diphenhydramine and is experiencing a severe or life-threatening situation (eg, dystonic laryngeal or pharyngeal spasms). 

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