Wheezing and dyspnea

Respiratory Effects. No histological alterations were observed in the trachea and lungs of rats administered daily doses of up to 140 mg 4-nitrophenol/kg by gavage for 13 weeks (Hazleton 1989). However, wheezing and dyspnea were observed in rats given doses of 70 mg/kg or more that died prematurely during the study. A dose of 25 mg 4-nitrophenol/kg was without effect. 

Bronchospasm, which can be life-threatening, can be precipitated by beta-blocker eye-drops. Even betai-selective antagonists, such as betaxolol, can cause a substantial reduction in forced expiratory volume. Wheezing and dyspnea have been reported among patients using betaxolol the symptoms resolved after withdrawal. A cross-sectional study has shown that ophthalmologists were more aware than chest physicians about the use of beta-blocker eye-drops by patients with obstructive airways disease patient awareness was also poor (38,107). 

Dose-dependent inflammatory reactions in the upper and lower airway begin to develop several hours after exposure and progress over several days. Burning nasal pain, epistaxis, sinus pain, laryngitis, loss of taste and smell, cough, wheezing, and dyspnea may occur. Necrosis of respiratory epithelium can cause pseudomembrane formation and local airway obstruction. 

Ozone can aggravate asthma and increase susceptibility to respiratory diseases such as pneumonia and bronchitis. The TClo is 50 ppm. Pulmonary symptoms at low levels (60-200 ppm) include substernal pain, cough, dry throat, wheezing, and dyspnea. The American Conference of Governmental Industrial Hygienists (ACGIH) lists ozone as A4 (not classifiable as a human carcinogen). 

Symptoms simulate asthma with cough, wheezing, and dyspnea predominating. 

Onset is rapid and the eyes and respiratory system are most affected. Low-level exposure causes tightness of the chest, rhinorrhea and salivation. Dimming of vision due to miosis, eye pain and headache then follow. On examination, the pupils are constricted and the conjunctivae hyperaemic. These effects may last several hours after cessation of exposure and the headache and visual problems several days. In severe cases, salivation and rhinorrhea are more marked, and wheezing and dyspnea are prominent. Other effects, such as abdominal pain, vomiting, involuntary defecation and micturition, weakness, fasciculation and convulsion, follow depending on the degree of systemic absorption. Death may occur from respiratory failure. 

For wheezing and dyspnea, add Herba Ephedrae Ma Huang) and Semen Pruni Armeniacae Xing Ren). 

CHRONIC HEALTH RISKS reactive airways dysfunction syndrome (RADS), referring to asthma persisting after exposure to irritants persistence of respiratory symptoms and airway hyper-reactivity for at least 3 months symptoms simulating asthma, with cough, wheezing, and dyspnea prolonged exposure has been associated with allergic contact dermatitis repeated exposure to wood dust and other irritants has contributed to risk of sinonasal neoplasms (nasal cancer). 

A. Thermal and irritant effects include singed nasal hairs, carbonaceous material in the nose and pharynx, cough, wheezing, and dyspnea. Stridor is an ominous finding that suggests imminent airway compromise due to swelling in and around the larynx. Pulmonary edema, pneumonitis, and adult respiratory distress syndrome (ARDS) may occur. Intimation of steam is strongly associated with deep thermal injury but is not complicated by systemic toxicity. 

Symptoms may include dyspnea, cough, wheezing, and chest tightness. These symptoms may be continual, episodic, seasonal, or occur in association with known triggers. 

After removal from exposure, some patients have had resolution of symptoms. The early detection of TDI-induced occupational asthma and the prompt removal of sensitized workers from exposure may increase the chances of remission. " However, there is evidence from several studies that individuals with TDI-induced asthma may continue to have symptoms of dyspnea and wheezing and bronchial hyperreactivity for 2 or more years after cessation of exposure. In one study, patients with TDI-induced asthma who continued to have exposure to TDI for 2 more years had, as a rule, marked abnormal decreases in spirometric parameters and increases in nonspecific hyperreactivity. In another study, 6 of 12 workers with a convincing history of TDI-... 

Relief of symptoms, such as wheezing, congestion, and dyspnea... 

An asthmatic patient using inhaled budesonide and salbutamol developed an acute asthma attack. Despite emergency treatment the patient deteriorated, requiring endotracheal intubation and assisted ventilation, and there was no improvement until the glucocorticoid was withdrawn, after which there was steady improvement. Skin prick tests with prednisolone, sodium hemisuccinate, and 6-methylprednisolone-sodium hemisuccinate were positive. Thirty minutes after intradermal 6-methylprednisolone-sodium hemisuccinate 4 mg, the patient developed a dry cough, dyspnea, and wheezing and a 17% fall in FEVi. 

A 25-year-old man with intermittent metamfetamine use developed facial edema, pruritus, and dyspnea 45 minutes after injecting a mixture of crushed marijuana leaves and heated water. He was anxious, and had tachjrpnea, respiratory stridor, wheezing, edema of the face and oral mucosa, and truncal urticaria. There was mild pre-renal uremia and urine toxicology was positive for metamfetamine and marijuana. Skin testing was not done. With appropriate medical intervention there was resolution of symptoms within a day. 

A 63-year-old woman with glomerulonephritis underwent angiography. She had a history of an immediate adverse reaction to lidocaine and of dyspnea, wheeze, and paresthesia of the fingers to repeated infusion of contrast media. Several hours after the last procedure she developed a generalized pruriginous maculopapular rash. 

A 40-year-old woman with no personal or family history of asthma had dyspnea, wheezing, and nasal symptoms for 2 years whenever she used toothpaste and/or ingested mint confections. She had no history of aspirin sensitivity, and a challenge test with a menthol solution diluted in alcohol ruled out any possibihty that the asthma had been caused by preservatives, dyes, or other additives. 

After administration of vinorelbine, chest pain occurs in up to 5% of patients. However, subsequent analysis showed that most patients had underlying cardiovascular disease or a tumor in the chest, making interpretation difficult (2,20). Three patients developed acute cardiopulmonary toxicity after vinorelbine therapy (25). The symptoms mimicked acute cardiac ischemia, but with no electrocardiographic changes or raised cardiac enzymes. In two patients, tachypnea, rales, wheezing, and severe dyspnea responded to inhaled salbutamol. One patient developed pulmonary edema and bilateral pleural effusions, which contained no malignant cells when drained. 

Acute shortness of breath and bronchospasm have been reported after the administration of vinca alkaloids, for example vinblastine and vindesine (30-34). The respiratory effects, including abrupt onset of progressive dyspnea, non-productive cough, pleuritic chest pain, profound wheezing, and diffuse basal crackles, were more common when mitomycin was used concomitantly. The onset of symptoms can be rapid (for... 

Chronic inhalation exposure results in severe lung effects that are characterized by asthma-like reactions characterized by dyspnea, wheezing, and bronchial constriction. The US EPA has neither established an RfC (for inhalation exposure) nor an RfD (for oral exposure) for TDI. 

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