A patient presents with wheezing or bronchospasm. What is the primary inhaled bronchodilator therapy?

A patient presents with wheezing or bronchospasm. What is the primary inhaled bronchodilator therapy?

• A. Oxygen therapy only
• B. Albuterol 2.5 mg in 3 mL SVN; repeat until improvement
• C. Ipratropium 2.5 mL 0.02% SVN
• D. Systemic corticosteroids

Answer: (B)

In acute bronchospasm, the fastest, most effective relief comes from an inhaled short-acting bronchodilator that directly relaxes airway smooth muscle. The primary choice is a beta-2 agonist like albuterol, delivered by nebulization or inhaler, because it rapidly activates receptors on the bronchial smooth muscle, increases cyclic AMP, and causes quick bronchodilation. A common, effective dose is 2.5 mg of albuterol in 3 mL of saline via a small-volume nebulizer, and it can be repeated as needed until there’s improvement. In practice, dosing may be continued or even given continuously in severe cases while monitoring for side effects such as tachycardia or tremor. Oxygen therapy may be added to address hypoxemia, but it doesn’t replace bronchodilation. Ipratropium can be used as an adjunct bronchodilator in some situations, but it’s not the primary inhaled bronchodilator. Systemic corticosteroids help inflammation and take longer to work, so they’re not the immediate bronchodilator choice.

In acute bronchospasm, the fastest, most effective relief comes from an inhaled short-acting bronchodilator that directly relaxes airway smooth muscle. The primary choice is a beta-2 agonist like albuterol, delivered by nebulization or inhaler, because it rapidly activates receptors on the bronchial smooth muscle, increases cyclic AMP, and causes quick bronchodilation. A common, effective dose is 2.5 mg of albuterol in 3 mL of saline via a small-volume nebulizer, and it can be repeated as needed until there’s improvement. In practice, dosing may be continued or even given continuously in severe cases while monitoring for side effects such as tachycardia or tremor. Oxygen therapy may be added to address hypoxemia, but it doesn’t replace bronchodilation. Ipratropium can be used as an adjunct bronchodilator in some situations, but it’s not the primary inhaled bronchodilator. Systemic corticosteroids help inflammation and take longer to work, so they’re not the immediate bronchodilator choice.