sprint123 wrote:
Acute Exacerbation in adults :
1.Inhaled beta-2 agonist
2.Theophylline infusion
3.Ipratropium as last resort
Theophylline is rarely used anymore due to narrow Therapeutic index... instead:
-O2
-inhaled B2-agonist
-inhaled steroids
-Ipratropium
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| prathapdoctor
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Guys, we must start giving oral corticosteroids in cases of acute exacerbation, unresponsive to inhaled Beta two agonists.
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| ssrpk
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there are two components to asthma, bronchoconstriction superimposed on chronic airway inflammation.
now patient having an acute attack not responding to beta agonists must be given systemic steroids to overcome the flare up of airway inflammation
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| prasannakumar
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frnds.........when do we use zileuton n zafirlucast? acute exacerbation or maintenance.
is there any role of magnesium in the Rx of asthma exacerbation?
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| dr_arc
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LTD4antagonists zafirleukast etc are used in steroid dependent asthamatics to try to take them off steroids.
i am not aware of the exact status of magnesium in standard asthma care protocols but magnesium is a bronchodilator and has been tried in mild asthmatics, has even been studied in severe asthamatics with studies that IV MgSo4 takes less time than corticosteroids for it s action.infact asthamatics with diets rich in magnesium are supposed to have better lung functions.
i hope someone else can shed some light on this. i doubt though that it is as yet a part of any std care for astma mgmt.
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| prasannakumar
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thanks arc....but in kap notes i read...zil & zaf r used in severe asthma resistant to max doses of inhaled steroids.....any comment...
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| dr_arc
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yes prassanna you are right. zil and zaf are used in pts on maximum doses of inhaled steroids rather than straightaway putting them on systemic steroids.thanks for reminding me of that
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| cirus
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firstfrom what I know its accord to present
the first drug is always a beta agonist, if it doesn't respond IV Hydrocortisone is the next step esp if there are poor criteria ( mostly presented as normalized CO2)
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