Drug treatment of shortness of breath
If the cause of shortness of breath is a pathology of the respiratory system, it is recommended that the extended drinking mode (rich alkaline water).At the expressed symptoms of intoxication conducted infusion therapy - intravenous fluids.For this purpose, apply saline gemodez, polyglukin, reopoligljukin and some other liquids.However, in patients with shortness of breath caused by pulmonary edema, fluid administration is strictly limited, and intravenous fluids held in conjunction with diuretics controlled diuresis.Intravenous fluid is required when hematic mechanism of dyspnea, which was caused by poisoning.Diet appointed rich in vitamins and microelements.
If the cause of dyspnea is bronchospasm, then drug treatment should be directed at eliminating bronchospasm, their expansion.To this end, the following groups of drugs are used.
1. Selective β2-agonists.For the duration of action of drugs are classified into a means of short-term and long-acting.The first is used to relieve symptoms of acute dysp
For short-acting drugs include:
• salbutamol (Ventolin) - comes in tablet form at 2 and 4 mg, administered in a dose for children up to 2 years 100 mg / kg 4 times a day, over 2 years 1-2 mg,adults - but 2-4 mg 3-4 times a day.The most commonly used dose inhalers for inhalation powders, and solutions for a nebulizer;
• fenoterol (Berotec) - metered aerosol, one dose (inhalation) which contains 100 or 200 mg (1-2 doses but 3-4 times daily), as well as solution for inhalation by nebulization (0.5-1ml per inhalation);Terbutaline
• - available in tablets of 2.5 mg and 5 mg, solutions for injection (0.1-0.3 ml for i.m.), inhalation (0.5-1 ml per inhalation) and metered in the form of (025 mg per dose, 1-2 dose 3-4 times a day).
For long-acting drugs include:
• Long-acting salbutamol (Saltos, volmaks), comes in the form of tablets 8 mg, appointed by half or a whole tablet 2 times a day;
• formoterol (Foradil, Oxis) - the drug has the form of capsules for 12 mg and a metered dose inhaler (at 4.5-9 g 1-2 times a day);Clenbuterol
• - available in tablets of 20 mg and in syrup but 5 mg in 1 ml administered to children under 2 years of 5 ml, 2 times a day, 2-4 years - 5 ml, 3 times a day, 4-6years - 10 ml, 2 times a day, 6-12 years - 15 ml, 2 times a day, over 12 years and adults - 1 tablet 2 times a day;
• salmeterol (Salmeter, Serevent) - metered spray of 25 micrograms per dose, and powder for inhalation by a dose of 50 ug, a dose is assigned to 1 1 -2 times a day.
2. Medications that cause relaxation of the muscles of the bronchi (nicotinic acetylcholine receptor blockers m):
• npratropium bromide (Atrovent) - metered dose inhaler 20 micrograms per dose, is used for 1 to 2 doses 3-4 times a day, as well ascapsules of 200 mg - 3.4 1 capsule twice a day and injection solution through a nebulizer.
3. Combination products.
• berodual comprises fenoterol and ipratropium bromide - is produced in the form of a metered aerosol dose of 20 ug, a dose 1-2 times a day, 2-3, as well as a solution for inhalation by nebulization;
• Ditek - a combination of fenoterol and kromogli kata - a form of a metered dose inhaler, which is used for 1 to 2 doses 3-4 times a day.
• Short-acting: eufillin is available as tablets (150 mg, administered at a dose of 7-10 mg / kg), 2.4% solution for intravenous administration in 10 ml vial (used indose of 4.5-5 mg / kg);
• long-acting: teopek (but tablets of 100, 200 and 300 mg) teotard (at 350 and 200. 500 mg) eufilong (capsules 250 and 375 mg), and the other - the rate of 10-15 mg / kg.
If the main cause of shortness of breath are inflammatory changes in the airways wall, then apply anti-inflammatory therapy.
Anti-inflammatory (basic) therapy, used in bronchial asthma
1. Non-steroidal anti-inflammatory drugs inhibit the release of substances involved in inflammation.Preference is given to the inhalation route of administration of drugs (aerosol spacer, nebulizer).These include:
• cromolyn sodium (fed) - dose inhaler (1 mg in 1 dose), powder for inhalation in capsules (1 capsule 20 mg);
• nedocromil sodium (tayled) - dose inhaler (2 mg in 1 dose), apply 2 doses 4 times a day;
• Nalkrom - represented capsules of 100 mg.Children under 2 years appoint 20-40 mg / kg / day, from 2 to 14 years - 1 capsule 4 times a day.
2. The steroid (hormonal) anti-inflammatory agents.At present, even in mild asthma recommended basic therapy with glucocorticosteroids.Preference is given to the inhalation route of administration of drugs.
• beclomethasone dipropionate (aldetsin, bekotid, beklomet, Beclason) - dose inhalers (1 dose contains 50, 100 and 250 micrograms).Apply 100 mg 2-4 times a day, depending on the severity of the disease;
• budesonide (1 dose of 100 and 200 micrograms).Apply 100-200 mg 2 times a day;
• Pulmicort - is the solution to 0,125, 0.25 and 0.5 mg / ml, available in 2 ml ampoules;
• fluticasone propionate (fliksotid) (1 dose of 50, 125 and 200 micrograms).Apply 2 times a day.
advantage inhalation route of administration of drugs is the lack of influence of hormones on the entire body, they act directly on the respiratory system.
systemic steroids are used With the ineffectiveness of inhaled hormones.These include hydrocortisone (5 mg / kg per day), prednisolone (1.2 mg / kg per day), dexamethasone (0.1-0.2 mg / kg per day).These preparations are administered orally in tablet form, as well as intramuscularly, and intravenously as a solution.However, for the relief of acute dyspnea occurred infrequently treatment begins with parenteral administration of glucocorticosteroids.
to improve airway inflammatory diseases of the respiratory tract therapy connected drugs, thinning mucus and improving its expectoration.
These tools include mucolytic and expectorant drugs:
• drugs group atsetitsisteina (ACC, mukobene);
• medicines that are based on karbotsisteina: bronkatar, karbotsistein, Mucodyne, mukopront etc .;
• bromhexine preparations: bromhexine, bromoxynil, bronhosan, Solvin etc .;
• funds for ambroxol based: ambrobene, ambrogeksal, ambroxol, Ambrosan, Lasolvan, haliksol and others;
If the cause of shortness of breath is an allergic inflammation of the airways, such as asthma, the treatment is added antihistamines:
• expectorant medicines: herbal cough syrup "Dr. Mom", marshmallow root, mukaltin, licorice root,sodium benzoate, the infusion of plantain, mother and stepmother, thyme, rosemary, violet tricolor, pine buds, oregano, cyanosis azure, Thermopsis and some others.
• diazolin - use 1 capsule 2-3 times a day;Diphenhydramine
• - 2% solution administered intramuscularly at 0.1 mL per year of life, as a tablet - the rate of 0.5 mg / kg per day;
• suprastin - available in tablets of 25 mg (applied at the rate of 1-2 mg / kg per day), a 2% solution in the ampoule and 1 ml (at the rate of 0.1 ml per year of life);
• Tavegilum - inside a pill 1-2 mg / kg per day intramuscularly or - 0,025 mg / kg per day;
• fenistil - in the form of a solution, it is assigned to 10 drops for children from 1 to 3 years, 20 drops - for children older than 3 years, older than 12 years and adults - 1 tablet 2-3 times a day;
• Claritin (loratodin, lorageksal) - available in tablets of 10 mg, for children weighing up to 30 kg - in 1/2 tablets 1 time per day, over 30 kg and adults on the whole tablet 1 time per day;Klarisens
• - in syrup containing 5 mg per 5 ml;
• cetirizine (tsetrin, zirtek) - drops for intake - children from 6 to 12 months - 5 drops of 1 times a day, from 1 to 2 years of age - 5 drops 2 times a day, 2-6 years -5 drops 2 times a day, or 10 drops once, older than 6 years and adults - 10-20 drops or 1 tablet (10 mg), 1 per day;
• erius (dezloratodin) - comes in tablet form and syrup.Children aged 12 months to 5 years - 1.25 mg per day (2.5 ml - 1.2 by measuring spoon), 6-11 - 2.5 mg per day (5 mL - 1 scoop)older than 12 years and adults - 5 mg per day - 1 tablet or 10 ml syrup 1 time per day.If
cause dyspnea constrictive laryngotracheitis is caused by a viral infection, the antiviral treatment means are connected.
In severe disease is possible to use the donor immunoglobulin.In the third degree of stenotic laryngotracheitis performed laryngoscopy, intubation with a translation into the artificial lung ventilation.
inhalations with saline.
good effect on dyspnea has diversionary therapy: hot foot baths, mustard plasters on the calf muscles.
If the cause of shortness of breath is the development of cardiac asthma, the treatment is carried out cardiac glycosides:
• digoxin - children drug is given at the rate of 50-80 mg / kg, the estimated amount of the drug may be administered for 1-7 days.The drug is available in tablet form 65, 100, 125 and 250 mg, and capsules with 0.025% solution for injections to 1 ml and 2;
• strofantin - children under 2 years of drug is given at the rate of 10 mg / kg, over 2 years old - 7 mg / kg as a loading dose is divided into 1-7 days.Means produced in the form of 0.025% solution and 0.05% solution for injections in ampoules of 1 ml;
• Korglikon - the drug is administered to children from 2 to 5 years 0.2-0.5 ml, from 6 to 12 years - 0.5-0.75 ml, over 12 years - 0.75-1 ml.Means produced in the form of 0.06% solution in a 1 ml ampoule, is administered before administering the medication in 10-20 ml glucose solution.
If the cause of shortness of breath is an abundant effusion in the pleural cavity, the pleural cavity puncture is performed.
reasons that can cause both angina and myocardial infarction (MI), are:
• physical overload;
• emotional stress;
• significant hypothermia;
• hypertensive crisis, especially against the background of atherosclerotic changes of vessels;
• sudden change in the weather;
• alcohol abuse;
• thrombosis of the coronary arteries (often leads to a heart attack), which can develop after massive injuries, fractures of long bones, and gynecological surgery, in patients with thrombophlebitis.