Status asthmaticus, corticosteroids

The corticosteroids are contraindicated in patients with hypersensitivity to the corticosteroids, acute bron-chospasm, status asthmaticus, or other acute episodes of... 

The corticosteroids are effective in most children and adults with asthma. They are beneficial for the treatment of both acute and chronic aspects of the disease. Inhaled corticosteroids, including triamcinolone ace-tonide (Azmflcort),beclomethasone dipropionate (Beclo-vent, Vancerit), flunisolide AeroBid), and fluticasone (Flovent), are indicated for maintenance treatment of asthma as prophylactic therapy. Inhaled corticosteroids are not effective for relief of acute episodes of severe bronchospasm. Systemic corticosteroids, including prednisone and prednisolone, are used for the short-term treatment of asthma exacerbations that do not respond to (32-adrenoceptor agonists and aerosol corticosteroids. Systemic corticosteroids, along with other treatments, are also used to control status asthmaticus. Because of the side effects produced by systemically administered corticosteroids, they should not be used for maintenance therapy unless all other treatment options have been exhausted. 

B. Status asthmaticus is a dangerous exacerbation of asthma symptoms. It requires immediate and aggressive treatment with oxygen, inhaled bronchodilators, and systemic corticosteroids. Hospitalization of the patient is often indicated. By definition, status asthmaticus is not a condition in which symptoms are well controlled. Neither cromolyn sodium nor a leukotriene modulator is indicated for the treatment of status asthmaticus, as their onset of action is too slow. Status asthmaticus often does not resolve without aggressive intervention. Indeed, the patient s condition can deteriorate rapidly to death. Upper respiratory tract infection or excessive exposure to an allergen often precedes status asthmaticus, as does increased use of inhaled bronchodilators. 

Contraindications Hypersensitivity to any corticosteroid, persistently positive sputum cultures for Candida albicans, status asthmaticus (inhalation), systemic fungal infections, untreated localized infection involving nasal mucosa. 

Methylprednisolone Succinate and Acetate (Solu-Medrol, Depo-Medrol) [Steroid] Uses Tx inflammation d/t anaphylaxis and asthma suspected SCI Action Adrenal corticosteroid Dose Adults. Anaphylaxis/ status asthmaticus 125-250 mg IV/IM Suspected SCI Load w/ 30 mg/kg then inf... 

Omalizumab is indicated for adults and adolescents older than 12 years of age with allergies and moderate to severe persistent asthma. In this population, it has proven to be effective in reducing the dependency on inhaled and oral corticosteroids and in decreasing the frequency of asthma exacerbations. Omalizumab is not an acute bron-chodilator and should not be used as a rescue medication or as a treatment of status asthmaticus. 

Parenteral corticosteroids such as prednisolone are lifesaving in status asthmaticus. They probably act by reducing production of leukotrienes (see Chapter 18). The answer is (G). Aminophylline is a salt of theophylline. Like the base theophylline, aminophylline can cause severe and potentially lethal overdose toxicity. The answer is (A). 

Routine modern therapy of severe exacerbations of asthma includes oxygen in addition to frequent inhalation of p -selective bronchodilators and. frequently, systemic corticosteroids. Therapy of status asthmaticus is more complicated, requiring intubation and respiratory assistance, sedation, parenteral corticosteroids, and bronchodilators. 

Status asthmaticus not responsive to intravenous amino-phylline and sympathomimetic therapy is an indication for hospitalization. Intravenous aminophylline should be continued, and intravenous corticosteroids may be required in doses equivalent to that described for orally administered prednisone. The intravenous steroid should be limited to five to seven days, and therapy switched to beclomethasone or an alternate-day oral... 

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