What medications are most often used in the prevention of asthma exacerbations?
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Inhaled corticosteroids These anti-inflammatory drugs are the most effective and commonly used long-term control medications for asthma.
What is first line medication therapy for an asthma exacerbation?
Inhaled short-acting beta2 agonists are the cornerstones of treatment for acute asthma. An inhaler with a spacer is equivalent to nebulized short-acting beta2 agonist therapy in children and adults. Continuous beta2 agonist administration reduces hospital admissions in patients with severe acute asthma.
What sedative can be useful in RSI if patient is asthmatic?
Sedative use prevents or minimizes these effects. Furthermore, clinicians can sometimes select an induction agent that both facilitates RSI and ameliorates the patient’s underlying condition. As an example, ketamine can be used in severe asthma to reduce bronchospasm .
Which medication is contraindicated in the treatment of asthma exacerbations?
Anxiolytics and morphine are relatively contraindicated because they are associated with respiratory depression, and morphine may cause anaphylactoid reactions due to release of histamine by mast cells; these drugs may increase mortality and the need for mechanical ventilation.
Which class of medications is given to prevent asthma attacks?
Short-acting beta-adrenergic drugs are usually the best drugs for relieving asthma attacks. They also are used to prevent exercise-induced asthma. These drugs are referred to as bronchodilators because they stimulate beta-adrenergic receptors to widen (dilate) the airways.
What is first-line treatment for intermittent asthma?
Beta-agonists are considered first-line therapy for intermittent asthmatics. If frequent use of beta-agonists occurs more than twice a week, controller therapy should be considered. For persistent asthma, low-dose inhaled corticosteroids are recommended in addition to reliever medication.
Why do you not want to intubate an asthmatic?
Intubating the severe asthmatic can be extremely challenging, as risks in- clude hypoxemia, worsening bronchospasm, pulmonary aspiration, tension pneumothorax, dynamic hyperinflation, hypotension, dysrhythmias, and even seizures.
Does intrathoracic pressure affect left ventricular function in acute pulmonary disease?
These findings suggest that negative intrathoracic pressure affects left ventricular function by increasing left ventricular transmural pressures and thus afterload. We conclude that large intrathoracic-pressure changes, such as those that occur in acute pulmonary disease, can influence cardiac performance.
What intrathoracic pressure do you need to take a breath?
For someone to take a breath, they need to be able to generate a negative intrathoracic pressure (-2 or -3cm H2O). They already have a higher intrathoracic pressure than normal and so have further to go to be able to generate the negative pressure required for a breath.
When is a positive intrathoracic pressure dangerous?
Clearly, there are certain clinical situations where the effect of a positive intrathoracic pressure may cause major compromise secondary to cardiac output by impeding venous return.
How is intrathoracic pressure affected by spontaneous inspiration during cardiac arrest?
Spontaneous inspiration produces a negative pleural pressure, and the reduction in intrathoracic pressure is transmitted to the right atrium.