The Efficacy of Intravenous Theophylline in Children With Severe Status Asthmaticus

Asthma is a serious health problem throughout the world. During the past two decades, many scientific advances have improved our understanding of asthma and ability to manage and control it effectively. However, recommendations for asthma care need to be adapted to local conditions, resources and services. Since it was formed in 1993, the Global Initiative for Asthma, a network of individuals, organisations and public health officials, has played a leading role in disseminating information about the care of patients with asthma based on a process of continuous review of published scientific investigations. A comprehensive workshop report entitled ''A Global Strategy for Asthma Management and Prevention'', first published in 1995, has been widely adopted, translated and reproduced, and forms the basis for many national guidelines. The 2006 report contains important new themes. First, it asserts that ''it is reasonable to expect that in most patients with asthma, control of the disease can and should be achieved and maintained,'' and recommends a change in approach to asthma management, with asthma control, rather than asthma severity, being the focus of treatment decisions. The importance of the patient-care giver partnership and guided self-management, along with setting goals for treatment, are also emphasised.

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“…Benefit as add-on treatment has been shown in children with near-fatal asthma but not in adults [348].…”

Section: Initial Assessmentmentioning

confidence: 99%

Global strategy for asthma management and prevention: GINA executive summary

Bateman

Ss²,

Barnes³

et al. 2008

European Respiratory Journal

2,638

2,301

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“…It has been used successfully in adults, in low-dose, as adjunct to standard therapy for its anti-inflammatory properties [1]. Theophylline is useful as an oral rescue medication in patients with status asthmaticus [26]. Side effects can be significant and include nausea, vomiting, arrhythmias, headache, and seizures.…”

Section: Methylxanthinesmentioning

confidence: 99%

“…Terbutaline may be preferable to epinephrine in the pregnant patient due to its tocolyticproperties ISSN:2155-6121 JAT, an open access journal J Aller Ther Asthma [57,[70][71][72][73]. Theophylline (or intravenous aminophylline) may be added for refractory bronchospasm [26,74].…”

Section: Intraoperative Managementmentioning

confidence: 99%

The Perioperative Management of Asthma

Applegate

2013

J Allergy Ther

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Anesthesiologists encounter asthmatic patients routinely. This common disease frequently complicates the perioperative care of those patients who live with it and can occasionally lead to life-threatening complications. This review takes the anesthesiologist's perspective to discuss asthma and how asthmatic patients can be safely guided through an anesthetic. We will discuss frequently used asthma medications, pre-operative disease optimization, management of intra-operative bronchospasm, and post-operative considerations for asthmatic patients. Anesthesiologists can make a positive difference in the outcomes of these patients with proper preoperative evaluation using a stepwise approach to disease management and by minimizing bronchoconstriction and effectively treating it when it develops.

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“…Yung e colaboradores 47 evidenciaram, em uma população de 163 pacientes (43% admitidos em UTI), com faixa etária de 1 a 19 anos, uma melhora no VEF 1 com 6 horas, uma menor necessidade de O 2 ao longo de 30 horas (6 horas no grupo aminofilina vs. 18 horas no grupo placebo, p=0,015), e uma redução na probabilidade de intubação (0% no grupo aminofilina vs. 6% no grupo placebo, p=0,03). Resultados favoráveis também foram encontrados por Ream e colaboradores 48 ao avaliarem o benefício da adição de aminofilina no tratamento de 47 crianças, admitidas em uma unidade de terapia intensiva pediátrica por quadro de asma aguda grave. Todos os pacientes receberam salbutamol por via inalatória freqüente, brometo de ipratropium e metilprednisolona intravenosa.…”

Section: Outros Broncodilatadores: Metilxantinas E Sulfato De Magnésiounclassified

“…Tanto a teofilina quanto o seu sal solúvel, a aminofilina, são capazes de promover relaxamento da musculatura lisa brônquica. Além do mais, possuem outros efeitos potencialmente benéficos para o manejo do paciente com obstrução respiratória, na função muscular diafragmática, no drive ventilatório, no clearence mucociliar, na secreção de hormônio antidiuréti-co e na inflamação 48,49 .…”

Section: Outros Broncodilatadores: Metilxantinas E Sulfato De Magnésiounclassified

Controvérsias no manejo farmacológico da asma aguda infantil

Amantéa

Sánchez²,

Piva³

et al. 2002

J. Pediatr. (Rio J.)

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Objective: to present a review of controversial issues related to the pharmacological management of the treatment of acute asthma in children.Sources: articles published in national and international scientific journals. Data were selected from Lilacs and Medline databases.Summary of the findings: the article was organized into topics, presenting aspects on which there is consensus regarding the pharmacological treatment of asthma in children. Issues related to the use of metered dose inhaler versus nebulizers, the role of ß2-adrenergic drugs administered intravenously as well as the role of methylxanthine and magnesium sulfate are approached critically. Conclusions:Inhaled ß2-agonist drugs combined with corticosteroids remain the treatment of choice for acute episodes of asthma in children. Either nebulizers or metered dose inhalers connected to spacers are efficient for the relief of acute symptoms. Patients who are refractory to conventional treatment and develop severe acute asthma should receive ß2-agonist drugs intravenously, provided they are properly monitored. Methylxanthine and magnesium sulfate should be considered a second choice for selected patients.J Pediatr (Rio J) 2002; 78 (Supl.2): S151-S160: acute asthma, beta-agonist, magnesium sulfate, aminophylline. ResumoObjetivo: apresentar uma revisão acerca de questões controversas, relativas ao manejo farmacológico utilizado nos pacientes pediátricos portadores de asma aguda. Fontes dos dados: foram utilizadas informações de artigos publicados em revistas científicas nacionais e internacionais, selecionadas das bases de dados Lilacs e Medline.Síntese dos dados: o artigo foi estruturado em tópicos, apresentando aspectos consensuais no tratamento farmacológico da asma infantil. Questões relacionadas à utilização de inaladores dosimetrados versus nebulizadores, o papel das drogas ß 2 -adrenérgicas utilizadas pela via endovenosa, bem como das metilxantinas e do sulfato de magnésio, são abordados de maneira crítica.Conclusões: os ß 2 -agonistas administrados pela via inalatória, associados aos coricosteróides, permanecem o tratamento de eleição para episódios agudos de asma na população pediátrica. Tanto os nebulizadores quanto os inaladores dosimetrados, acoplados a espaçadores, são efetivos para alívio dos sintomas agudos. Pacientes refratários ao tratamento convencional, que evoluem para quadros de asma aguda grave, devem ter considerada a utilização de drogas ß 2 -agonistas pela via endovenosa, desde que adequadamente monitorizados. Quanto às metilxantinas e ao sulfato de magnésio, devem ser considerados alternativas secundárias para pacientes selecionados.J Pediatr (Rio J) 2002; 78 (Supl.2): S151-S160: asma aguda, beta-agonistas, sulfato de magnésio, aminofilina.

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The Efficacy of Intravenous Theophylline in Children With Severe Status Asthmaticus

Cited by 21 publications

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Global strategy for asthma management and prevention: GINA executive summary

Global strategy for asthma management and prevention: GINA executive summary

The Perioperative Management of Asthma

Controvérsias no manejo farmacológico da asma aguda infantil

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