General Medicine Question And Answers<\/a><\/strong><\/p>\nManagement Asthmaticus.<\/strong><\/p>\nStatus Asthmaticus Treatment<\/h2>\n Treatment of severe acute asthma at Home<\/strong><\/p>\n\nAdminister oxygen (40\u201360%) through mask, if available.<\/li>\n Bronchodilator: IV Aminophylline i.e. 250\u2013375 mg in 20 mL of saline slowly after checking blood pressure Or IV, Salbutamol 250 \u00b5g in 20 mL of saline over 10 min Or IV.<\/li>\n Terbutaline 250 \u00b5g in 20 mL of saline over 10 min.<\/li>\n Alternatively<\/li>\n Salbutamol (5 mg) or terbutaline (10 mg) by nebulizer.<\/li>\n Give hydrocortisone sodium succinate 200 mg IV stat.<\/li>\n Arrange for emergency admission to a hospital in ambulance equipped with oxygen therapy.<\/li>\n Give prednisolone 60 mg orally<\/li>\n<\/ol>\nIn Hospital Treatment Asthmaticus.<\/strong><\/p>\n\nHigh conc. of oxygen, i.e. 40\u201360% at high flow rate should be given. It is recommended in all cases even in the presence of CO2 retention. \nOxygen supply should be started immediately through mask, and concentration adjusted according to blood gas measurement. \nPaO2 of greater than 8.5 to 9.0 kPa should be maintained ifpossible.<\/li>\n High doses of salbutamol, i.e. 2.5\u20135 mg or terbutaline 5\u2013l0 mg by nebulizer should be given initially and repeated after 30 minutes, necessary. \nIf no improvement occurs with nebulised therapy then 250 \u00b5g of salbutamol or terbutaline may be given by IV infusion over 10 minutes.<\/li>\n In all severe cases of acute asthma systemic corticosteroids i.e. hydrocortisone 200 mg IV stat and then 4 to 6 hourly or oral prednisolone 40\u201360 mg\/day to tide over the crisis.<\/li>\n Systemic bronchodilators such as aminophylline 250 mg IV over a period of 30 minutes may be given immediately followed by either 8 hours doses or continuous infusion not exceeding total dose of 1.5 g\/day.<\/li>\n Ipratropium bromide can be used in acute severe asthma in doses of 0.5 mg added to a nebulised beta\u00adagonist.<\/li>\n Reassess the patient by PEFR and arterial blood gas analysis. If recovery is good, continue oxygen therapy and oral prednisolone, i.e. 40 mg\/day in decreasing doses is given. Nebulized \u03b2-adrenoreceptor agonist may be continued every 4\u20136 hours and then replaced by metered dose inhalation. IV hydrocortisone 200 mg 6 hourly may be continued for 24\u201348 hours in severe cases followed by oral steroids. \nlf response is not good, then shift the patient in respiratory intensive care for assisted ventilation.<\/li>\n Assisted ventilation: Mechanical ventilation can be life saving in few patients, who are critically ill.<\/li>\n<\/ol>\nPatient Education and Monitoring of Therapy<\/strong><\/p>\n\nEducate the patients about the nature of disease as well as its treatment. \nPatients are trained to recognize the severity of their disease and monitor the response to therapy with the use of peak flwmeter.<\/li>\n Demonstrate the proper use of inhalation devices such as metered\u00addose inhalers (pressurized aerosol system),rotahaler (dry powder system) and nebulizers.<\/li>\n Encourage the usage of inhaler therapy because it is effctive in lower dosage together with a rapid onset of action and has less side effcts.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"Status Asthmaticus Treatment Status asthmaticus is a continuous state of breadthlessness without any period of relief. A prolong attack of continuous asthma with flctuations also comes under status asthmaticus. Clinical Features Asthmaticus. Presence of repeated dry cough which causes aggravation of dyspnea and respiratory distress. Patient sweats heavily and there is also presence of tachycardia. […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[3],"tags":[],"class_list":{"0":"post-10783","1":"post","2":"type-post","3":"status-publish","4":"format-standard","6":"category-general-medicine","7":"entry"},"yoast_head":"\n
Status Asthmaticus Treatment Notes - BDS Notes<\/title>\n \n \n \n \n \n \n \n \n \n \n \n \n \n\t \n\t \n\t \n