ADVICE, P.R.N.: Attacking asthma

October 2004 
Volume 34  Number 10
Pages 18 - 18
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    Recently a woman experiencing an acute asthma attack came to the clinic where I work. The nurse practitioner treated her with inhaled albuterol instead of epinephrine. Although the patient responded well, I was surprised at the choice of bronchodilator. Why not epinephrine? —S.S., FLA.

    If a patient is having an acute asthma attack, albuterol (Ventolin) is a good first choice for treating bronchospasm. Inhaled albuterol, a beta 2 -adrenergic agonist, provides rapid relief of bronchospasm and is safer than epinephrine because of epinephrine's cardiovascular effects. If symptoms don't improve, however, the patient may need additional treatment with anticholinergic drugs (such as ipratropium), corticosteroids, and supplemental oxygen. Subcutaneous or I.V. administration of another beta 2 -agonist, such as epinephrine or terbutaline, may be indicated to treat severe asthma exacerbations that don't respond to ...

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