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Bronchial asthma

It is administered subcutaneously: with a body weight of less than 60 kg - 0.3 ml, with a mass of 60 to 80 kg - 0.4 ml, with a mass of more than 80 kg - 0.5 ml.

Eufillin inhibits phosphodiesterase, which contributes to the accumulation of cAMP and the removal of bronchospasm. When prescribing aminophylline, contraindications should be taken into account, which include smoking and childhood, heart failure and acute coronary syndrome, chronic diseases of the lungs, liver and kidneys.

At AS, the loading dose of aminophylline is 3-6 mg / kg, it is administered intravenously dropwise for 20 minutes. Then, a maintenance drip infusion of the drug is carried out at the rate of 0.6 mg / kg per 1 h for a patient without concomitant pathology, 0.8 mg / kg per 1 h for smokers, 0.2 mg / kg per 1 h for congestive heart failure, pneumonia , diseases of the liver and kidneys, 0.4 mg / kg per 1 h in severe chronic lung diseases.

The effect of corticosteroid therapy is associated with suppression of airway inflammation and increased sensitivity to b-adrenergic drugs. The heavier the AS, the greater the evidence for immediate corticosteroid therapy. It is necessary to initially introduce a high dose of corticosteroids. The minimum dose is 30 mg of prednisone or 100 mg of hydrocortisone, or 4 mg of dexamethasone (celestone). If therapy is ineffective, increase the dose. At least every 6 hours, appropriate equivalent doses of these drugs are administered. Most patients are shown inhalation therapy with adrenergic agonists; (fenoterol, alupent, salbutamol). Exceptions are cases of drug overdose of sympathomimetics.

If the therapy does not work, intravenous administration of b-adrenergic agonists, for example, isoproterenol, diluted in 5% glucose solution, is indicated. Contraindications are heart disease (coronary cardiosclerosis, myocardial infarction), severe tachycardia and symptoms of tachyphylaxis, old age. The rate of administration of isoproterenol is 0.1 μg / kg per 1 min until tachycardia appears (heart rate 130 in 1 min or slightly more).

Infusion therapy is an essential component of AS treatment, aimed at replenishing fluid deficiency and eliminating hypovolemia; the total volume of infusion therapy is 3-5 liters per day. Hydration is carried out by introducing solutions containing a sufficient amount of free water (solutions

glucose), as well as hypo - and isotonic solutions of electrolytes containing sodium and chlorine. The indicators of adequate hydration are cessation of thirst, a moist tongue, restoration of normal diuresis, improved sputum evacuation, and a decrease in hematocrit to 0.30-0.40.

Fluorotan narcosis can be used in the treatment of a severe asthma attack that is not amenable to conventional therapy.

Artificial ventilation of the lungs. Indications for transferring patients from AS to mechanical ventilation should be very strict, since in this condition it often causes complications and is characterized by high mortality. At the same time, mechanical ventilation, if performed according to strict indications, is the only method that can prevent the further progression of hypoxia and hypercapnia.

Indications for mechanical ventilation:

1) the steady progression of AS, despite intensive care;

2) an increase in pCO2 and hypoxemia, confirmed by a series of analyzes;

3) the progression of symptoms from the central nervous system and coma;

4) increasing fatigue and exhaustion.

Mucolytics and expectorants are divided into two groups.

1. Proteolytic enzymes (trypsin, chymotrypsin) act by breaking peptide bonds of glycoproteins, reducing the viscosity and elasticity of sputum. They are effective for mucous and purulent sputum, having an anti-inflammatory effect, but can cause hemoptysis and allergic reactions.

2. Derivatives of cysteine ​​stimulate secretory activity in the ciliated epithelium of the tracheobronchial tree (mucosolvan, mucist), are used in the form of an aerosol of a 20% solution of 2-3 ml 2-3 times a day.
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Bronchial asthma

  1. SESSION 3 Acute respiratory failure. Laryngeal stenosis, cardiac asthma, bronchial asthma: symptoms, differential diagnosis, first aid. The principles of tracheostomy. The technique of artificial ventilation.
    Objective: To teach students to identify the clinical symptoms of acute respiratory failure in patients (victims), to conduct diffdiagnosis, assess the severity of the condition and effectively provide first aid in these conditions. Test questions 1. What are the causes of acute obstruction of the respiratory tract and its clinical manifestations. Features of first aid. 2.
  2. Bronchial asthma
    G. Lolor Jr., D. Teshkin. Bronchial asthma is one of the most common chronic lung diseases. It most often occurs in children, although it can begin at any age. Among children with bronchial asthma, there are 30% more boys than girls, and in boys the disease is more severe. In adolescence and in adults, the disease is more common in women.
  3. Bronchial asthma
    Bronchial asthma in children is a disease that develops on the basis of chronic inflammation of the bronchi, characterized by periodic attacks of difficulty breathing or choking as a result of widespread bronchial obstruction due to narrowing of the bronchi, hypersecretion of mucus, and swelling of the bronchial wall. Bronchial asthma is recorded in 5-10% of the child population. In the last
    The last decade is characterized by an increase in the incidence and severity of bronchial asthma (BA). In terms of social significance, this condition confidently goes to one of the first places among respiratory diseases. According to DJ Lane (1979), bronchial asthma is a disease that is relatively easy to recognize but difficult to define. From a vast array of definitions,
  5. Bronchial asthma
    The article “Bronchial asthma in children” is located in section 14 “Emergency conditions in pediatrics.” Bronchial asthma is a respiratory disease based on chronic inflammation and hyperresponsiveness of the bronchi with bronchial obstruction that changes over time. The cause of the call of the NSR is an acute attack of suffocation due to fully or partially reversible bronchial obstruction.
  6. Bronchial asthma.
    Bronchial asthma is a chronic recurrent inflammatory disease characterized by increased excitability of the tracheobronchial tree in response to various stimuli and leading to paroxysmal constriction of the airways (see lecture on immunopathology). There are two main types of disease: 1) exogenous, atopic (allergic, reagin-mediated) bronchial asthma;
  7. "Bronchial asthma"
    BRONCHIAL ASTHMA — a chronic recurrent disease with a primary lesion of the respiratory tract. It is characterized by altered reactivity of the bronchi. A mandatory sign of the disease is an asthma attack and / or asthmatic status. There are two forms of bronchial asthma - immunological and non-immunological - and a number of clinical and pathogenetic options: atonic,
  8. Bronchial asthma in children
    The article “Bronchial asthma” is located in section 4 “Emergency conditions for respiratory diseases”. Bronchial asthma in children develops on the basis of chronic allergic inflammation of the bronchi and their hyperreactivity. It is characterized by periodically occurring attacks of difficulty breathing or suffocation as a result of widespread bronchial obstruction due to
  9. Bronchial asthma
    Bronchial asthma is a chronic inflammatory disease of the respiratory tract, characterized by asthma attacks due to their obstruction. The pathogenesis of bronchial asthma is based on the complex interaction of inflammatory cells (eosinophils, mast cells), mediators and bronchial cells and tissues, due to a change in bronchial reactivity - primary (congenital or acquired under
  10. Bronchial asthma
    In the vast majority of cases, bronchial asthma is an allergic disease. More often it develops before pregnancy, but may first occur during pregnancy. Attacks of suffocation in some women develop at the beginning of pregnancy, in others in the second half. The occurrence of asthma in pregnant women is associated with changes in the body of a woman, in particular with a change in synthesis
    The reason is genetically determined internal defects that have formed in the prenatal period, during childbirth or in later life. But the necessarily changed sensitivity of the bronchial mucosa with a pathological reaction to acetylcholine, even if there are no clinical manifestations, + changes at the preclinical stage and other systems, for example, an increase in IG E, there may be changes
  12. Bronchial asthma
    Bronchial asthma is a chronic disease characterized by repeated attacks of expiratory dyspnea or suffocation caused by allergic reactions occurring in the tissues of the bronchi (mainly small bronchi and bronchioles). The urgency of the problem of bronchial asthma is currently determined by the increase in its prevalence and severity, up to a fatal outcome at altitude
  13. Bronchial asthma
    Currently, bronchial asthma (BA) takes a leading place in the structure of respiratory allergies in children. This disease attracts attention in connection with interesting hypotheses of pathogenesis, the lack of clear diagnostic criteria and the not always predicted effectiveness of therapy. A lot of controversy arises when defining AD as an independent nosological form. Currently under
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