Treatment for Pediatric bronchospasm

Specialties CRNA

Published

I'm not sure if this in the literature or not (probably) and I haven't really studied it yet, but...

If you have a 10kg kid with bronchospasm, what would you treatment be. I'm imagining, that in the pediatric population (and perhaps adults as well) that Epinephrine is the drug of choice. A cardiac arrest dose is 10mcg/kg, so knowing that Epi has greater efficacy for B2 receptors at lower doses, what kind of dose would you administer to the kid in the above situation?

I'm thinking 10-20 mcg and titrate.

Terbutaline is an IV B2 agonist, is it not?

Seems it's main use is keeping the bun in the oven though.

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Originally posted by Tenesma

low dose epinephrine is actually B2 selective to a certain degree

Not according to my pharmacology text, but what do text writers know ;)

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law of fives: time for a new textbook :D

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Yea, that sounds like a good idea. Which one are you referring to? A page # would also help expidite the search for this b2 selectivity of epinephrine. A preliminary search for this selectivity has yielded me nothing, but my only source available to me is the world wide web, (all my texts are at home :crying2: ). AND, as we all know, the web can be as reliable as overhearing a conversation in the bathroom so to speak, but I digress.

Take it easy on me, I'm still learning, but very interested. Have a good day!

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Acetylcholine is a bronchconstrictor so giving pre-op atropine or glycopyrolate decreases intra-op bronchospasm. These are effective IV, IM, or endotracheally.

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Terbutaline is an IV B2 agonist, is it not?

Seems it's main use is keeping the bun in the oven though.

Terbutaline (Brethine) is one of the first bronchiodilators (sorry, I don't feel like thinking about the spelling).

It has been replaced with newer (better) meds and is now primarily used to stop PTL.

My mom was severely asthmatic (with a strong emotional component) and had PTL . She credited Brethine for my existance.

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Isoproterenol, the quarternary atropine.

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Isoproterenol is a beta agonist.

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Must have been tired... what i meant to say was Ipratropium.

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Nitric oxide.

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nitric oxide??? what does that have to do with anything?

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nitric oxide??? what does that have to do with anything?

NO does help with hypoxia by limiting the lungs' vasoconstrictive response to hypoxia. I think it relaxes the vascular endothelium and dilates the pulmonary vessels.

I do remember that long term NO therapy oxidizes iron and causes methemoglobinemia, which inhibits the blood's oxygen-carrying capacity.

These are the only things I can remember about NO in regards to the respiratory system.

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