From the Guidelines
Bronchospasm treatment typically involves the use of short-acting β-agonists or anticholinergic bronchodilators.
Treatment Options
- Short-acting β-agonists: These are the first line of treatment for bronchospasm, as they provide quick relief from symptoms such as wheezing and shortness of breath 1.
- Anticholinergic bronchodilators: Ipratropium bromide is an example of an anticholinergic bronchodilator that can be used to control bronchospasm and relieve dyspnea 1.
- Theophylline: This medication can be considered for the treatment of chronic cough in patients with chronic bronchitis, but careful monitoring for complications is necessary 1.
Administration
- Inhaled route: The inhaled route of drug delivery is preferred, as it results in fewer adverse effects 1.
- Nebulizer: During acute exacerbations, some patients may find it easier to use a nebulizer to administer medication 1.
Dosing
- Short-acting β-agonists: The effect of short-acting β-agonists lasts 4-5 hours, and they can be administered as needed 1.
- Ipratropium bromide: The dosing of ipratropium bromide will depend on the individual patient's response to treatment and the severity of their symptoms 1.
From the Research
Treatment Options for Bronchospasm
- Inhaled bronchodilators are considered first-line treatment for acute exacerbations of asthma and bronchospasm 2
- Continuous bronchodilator administration is a novel option for the treatment of bronchospasm, which may be more effective than intermittent therapy for patients with severe airflow obstruction 2
- Inhaled beta-agonist therapy, such as albuterol, is commonly used to treat bronchospasm in both intubated and nonintubated patients 3
- Levosalbutamol, a chiral drug with (R)- and (S)- isomers, is now indicated for the treatment or prevention of bronchospasm with reversible obstructive airway disease 4
- Sevoflurane, a volatile anesthetic agent, has been used to treat life-threatening acute severe asthma and bronchospasm, providing both bronchodilator and sedative effects 5
Administration Methods
- Metered-dose inhalers (MDI) are commonly used to deliver beta 2-agonist bronchodilators, and can be effective in mechanically ventilated patients when used with a spacing device 3
- Administration of inhaled beta-agonist therapy by basic life support (BLS) units is less common than by advanced life support (ALS) units, with BLS administering inhaled beta-agonist therapy less than half the time 6
- ALS units are more likely to administer inhaled anticholinergic therapy and systemic corticosteroids than BLS units 6
Patient Considerations
- Pediatric patients are less likely to receive supplemental oxygen, inhaled beta-agonists, inhaled anticholinergics, or systemic corticosteroids than adult patients 6
- Patients with severe airflow obstruction may benefit from continuous bronchodilator administration 2
- Patients with life-threatening acute severe asthma may require mechanical ventilation under adequate sedation, and sevoflurane therapy may be beneficial in these cases 5