The following component of management protocol of status asthmaticus has now been shown to be useless
Status asthmaticus/Refractory asthma Any patient of asthma has the potential to develop acute severe asthma which may be life-threatening. Upper respiratory tract infection is the most common precipitant. Treatment of status asthmaticus:- (i) Hydrocoisone hemisuccinate 100 mg (or equivalent dose of another glucocoicoid) i.v. stat, followed by 100-200 mg 4-8 hourly infusion; may take upto 6 hours to act. (ii) Nebulized salbutamol (2.5-5 mg) + ipratro pium bromide (0.5 mg) intermittent inhalations driven by O2. (iii) High flow humidified oxygen inhalation. (iv) Salbutamol/terbutaline 0.4 mg i.m./s.c. may be added, since inhaled drug may not reach smaller bronchi due to severe narrowing/ plugging with secretions. (v) Intubation and mechanical ventilation, if needed. (vi) Treat chest infection with intensive anti biotic therapy. (vii) Correct dehydration and acidosis with saline + sod. bicarbonate/lactate infusion Ref:- kd tripathi; pg num :-233
Intravenous aminophylline
Intravenous hydrocoisone
Nebulized ipratropium bromide
Nebulized salbutamol
Respiratory system