ﺑﺎﺯﮔﺸﺖ ﺑﻪ ﺻﻔﺤﻪ ﻗﺒﻠﯽ
خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
medimedia.ir

Pharmacologic management of acute asthma exacerbations during pregnancy

Pharmacologic management of acute asthma exacerbations during pregnancy
  1. Beta2-agonist bronchodilator (nebulized or metered-dose inhaler)
Albuterol by MDI 4 to 8 puffs every 20 minutes up to 1 hour, then every 1 to 4 hours, as needed.
Albuterol by nebulizer 0.083% (2.5 mg/3 mL), 2.5 to 5 mg every 20 minutes for 3 doses and then 2.5 to 5 mg every 1 to 4 hours, as needed.
Albuterol by continuous nebulization, administering 10 to 15 mg per hour.
  1. Ipratropium
By nebulizer, 500 mcg every 20 minutes for 3 doses, then as needed. Can be given simultaneously with beta2-agonist.
By MDI, 4 to 8 inhalations every 20 minutes for 3 doses, then as needed.
  1. Systemic glucocorticoids (for those with a poor response to treatment after one hour, or with initial therapy for patients on chronic oral glucocorticoids)
For patients who can be managed at home: prednisone 40 to 60 mg per day in a single or divided dose.
For patients who require hospitalization: prednisone 40 to 80 mg daily in a single or divided dose (or the equivalent dose of methylprednisolone* intravenously) until peak flow reaches 70% of predicted or personal best, and then taper as patient improves.
For patients who have a life-threatening exacerbation, a higher initial dose of methylprednisolone, 60 to 80 mg every 6 to 12 hours, may be given intravenously, and then tapered as the patient improves, as above.
  1. For patients not responding to above therapies, consider adjunct therapies
Intravenous magnesium sulfate 2 g infused over 20 minutes, in absence of renal insufficiency.*
Subcutaneous terbutaline 0.25 mg every 20 minutes for up to 3 doses.

MDI: metered dose inhaler.

* For patients with renal insufficiency, a baseline serum magnesium level is assessed. The decision to use intravenous magnesium requires consideration of the potential benefit in terms of asthma and the anticipated risk of hypermagnesemia based on the degree of renal insufficiency and baseline serum magnesium level.
Adapted from: National Asthma Education and Prevention Program: Expert panel report III: Guidelines for the diagnosis and management of asthma. Bethesda, MD: National Heart, Lung, and Blood Institute, 2007. (NIH publication no. 08-4051) www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm (Accessed on May 12, 2011).
Graphic 67529 Version 11.0

آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟