Diagnosis and Management of Acute Respiratory Failure - Management Considerations - Pharmacologic Adjuncts

5 important questions on Diagnosis and Management of Acute Respiratory Failure - Management Considerations - Pharmacologic Adjuncts

What is the effect of B2-agonists in ARF?

Stimulation of B2-adrenergic receptor causes bronchial and vascular smooth-muscle relaxation.

How is B2 normally administered?

Inhalation or nebulizer

But in very ill patients with obstructive airway disease they are administered both by inhalation and subcutaneous injection.


Long acting B2-agonists do not have a role

What is the effect of anticholinergic agents in ARF?

Ipratropium bromide competes with acetylcholine at the bronchial receptor site, resulting in bronchial smooth-muscle relaxation.
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How are anticholinergic agents normally administered?

Nebulizer

  • It has a more delayed onsed that B2-agonist
  • Has more consistent bronchodilatory effects in COPD than in asthma
  • Addition to B2-agonist has a benefit in 30% of asthma patients

What is the effect of corticosteroids in ARF?

There is a central role of inflammation in obstructive airway disease.

Asthma doses: 80 mg/24h to >360 mg/24h
COPD doses: 1 mg/kg/24h


Bijwerking: acute myopathy

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