Treatment for Pediatric bronchospasm

[Brenna's Dad]

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.

[Brenna's Dad]

Terbutaline is an IV B2 agonist, is it not?

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

[Law of Fives]

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

[Tenesma]

law of fives: time for a new textbook

[Law of Fives]

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 ). 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!

[pasgasser]

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

[kids]

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.

[Brenna's Dad]

Isoproterenol, the quarternary atropine.

[pasgasser]

Isoproterenol is a beta agonist.

[Brenna's Dad]

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

[Diprivan/Vented]

Nitric oxide.

[Tenesma]

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

[DustinRN]

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.