From the Guidelines
A bronchospastic patient is someone who experiences bronchospasm, a condition characterized by sudden tightening of the muscles that line the airways (bronchi) in the lungs, causing narrowing of the air passages and difficulty breathing, as described in the study by 1. This condition is commonly seen in asthma, chronic obstructive pulmonary disease (COPD), and bronchitis.
Key Characteristics of Bronchospasm
- Sudden tightening of the muscles that line the airways
- Narrowing of the air passages
- Difficulty breathing
- Characteristic wheezing, coughing, chest tightness, and shortness of breath
Treatment and Management
Treatment typically involves bronchodilators like albuterol (2-4 puffs every 4-6 hours as needed), which can provide quick relief by relaxing the airway muscles, as recommended in the study by 1. For long-term management, inhaled corticosteroids such as fluticasone (1-2 puffs twice daily) may be prescribed to reduce inflammation. In severe cases, combination therapies like fluticasone/salmeterol (Advair) or budesonide/formoterol (Symbicort) might be used. Patients should avoid triggers like smoke, allergens, cold air, and respiratory infections.
Pathophysiology
Bronchospasm occurs because inflammatory mediators and neural mechanisms cause smooth muscle contraction in the airways, leading to the characteristic symptoms, as explained in the study by 1. The pathophysiology of exercise-induced bronchoconstriction (EIB) has been elucidated, and it is known that strenuous exercise creates a hyperosmolar environment, leading to mast cell degranulation and release of mediators, including leukotrienes, histamine, tryptase, and prostaglandins.
Diagnosis and Prevention
Diagnosis of EIB is made by using exercise or hyperosmolar surrogate challenges, such as EVH or mannitol, as described in the study by 1. Use of face masks can promote humidification and prevent water loss, attenuating EIB. Patients with EIB should be diagnosed by means of objective testing, preferably by using standardized bronchoprovocation challenge. The most effective treatment for bronchospasm is the use of short-acting β2-agonists, such as albuterol, to provide bronchodilation and bronchoprotection, as recommended in the study by 1.
From the FDA Drug Label
Albuterol sulfate inhalation solution is indicated for the relief of bronchospasm in patients 2 years of age and older with reversible obstructive airway disease and acute attacks of bronchospasm. A bronchospastic patient is someone who experiences bronchospasm, which is a temporary narrowing of the airways in the lungs that can cause difficulty breathing. This condition is often associated with reversible obstructive airway disease, such as asthma. Key points about bronchospastic patients include:
- They may experience acute attacks of bronchospasm that require relief medication, such as albuterol sulfate inhalation solution 2
- They often have reversible obstructive airway disease, which can be managed with medication and other treatments
- Bronchospasm can cause symptoms such as wheezing, coughing, and shortness of breath, which can be relieved with medications like albuterol sulfate inhalation solution 2
From the Research
Definition of a Bronchospastic Patient
A bronchospastic patient is an individual who experiences bronchospasm, a condition characterized by the constriction of the airways in the lungs, leading to difficulty breathing [ 3 , 4 ].
Characteristics of Bronchospasm
- Bronchospasm can be triggered by various factors, including asthma, chronic obstructive pulmonary disease (COPD), and the use of certain medications, such as beta-agonists [ 3 ].
- Symptoms of bronchospasm include shortness of breath, wheezing, and coughing [ 4 ].
- Bronchospasm can be treated with medications, such as bronchodilators, and other interventions, such as the use of a vibrating-mesh nebulizer [ 5 ].
Paradoxical Bronchoconstriction
- Paradoxical bronchoconstriction is a rare complication of bronchodilator therapy, where the airways constrict instead of dilating [ 3 , 4 ].
- The exact mechanism of paradoxical bronchoconstriction is unknown, but it is thought to be related to the formulation of the medication or the presence of preservatives [ 3 ].
- Clinicians should be aware of the risk of paradoxical bronchoconstriction and monitor patients closely for signs of bronchospasm when administering bronchodilators [ 4 ].