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Drugs Used in Lower Respiratory Disorders: Overview01:17

Drugs Used in Lower Respiratory Disorders: Overview

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Lower respiratory tract disorders present challenges that often require skilled and nuanced approaches for effective management. Common ailments, such as asthma and chronic obstructive pulmonary disease (COPD), have prompted the development of intricate treatment strategies involving bronchodilators and anti-inflammatory drugs, each tailored to ease breathing and revitalize the lungs.
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
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Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
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Antiasthma Drugs: β2-Adrenoceptor Agonists01:25

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Bronchodilators are critical in managing asthma, a chronic respiratory condition characterized by airway constriction due to inflammation and hyper-reactivity. Specifically, bronchodilators ease this constriction by relaxing the bronchial muscles, facilitating easier breathing.
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Inhaled Medications01:23

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Inhaled medications are crucial for managing chronic obstructive pulmonary disease (COPD) and asthma. They are essential for effective treatment and control, ensuring optimal respiratory health and well-being. Inhaled medication delivers drugs directly to the lungs, providing a rapid onset of action and reducing systemic side effects compared to oral or injectable medications. Three primary types of inhalation devices are used to administer these medications: nebulizers, metered-dose inhalers...
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Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
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Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
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Related Experiment Video

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Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
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[Decrease in the use of bronchodilators in the management of bronchiolitis after applying improvement initiatives].

David Andina Martínez1, Silvia Escalada Pellitero1, Pedro Viaño Nogueira2

  • 1Servicio de Urgencias, Hospital Infantil Universitario Niño Jesús, Madrid, España.

Anales De Pediatria
|June 15, 2021
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Summary

A quality improvement strategy significantly reduced bronchodilator use in children with acute bronchiolitis. This initiative decreased salbutamol and epinephrine prescriptions without impacting readmission rates.

Keywords:
Bronchodilator agentsBroncodilatadoresBronquiolitis agudaEmergency medical servicesEstrategia de mejora de la calidadGuías de práctica clínicaHospital pediatricsPediatría hospitalariaPractice guidelinesQuality improvementServicios de UrgenciasViral bronchiolitis

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Area of Science:

  • Pediatrics
  • Emergency Medicine
  • Quality Improvement

Context:

  • Acute bronchiolitis is a common pediatric respiratory illness with variable treatment practices.
  • Clinical Practice Guidelines recommend against unproven treatments, yet these are often used.
  • Bronchodilator use in acute bronchiolitis lacks demonstrated efficacy and contributes to practice variability.

Purpose:

  • To evaluate the impact of a sustained quality improvement strategy on bronchodilator prescription rates in acute bronchiolitis.
  • To assess changes in salbutamol and epinephrine use over four epidemic periods.
  • To determine if the intervention affected emergency department length of stay or admission/readmission rates.

Summary:

  • A five-year quality improvement initiative progressively restricted bronchodilator use for acute bronchiolitis.
  • Retrospective analysis of 1767 children showed significant decreases in salbutamol (51.2% to 7.8%) and epinephrine (12.9% to 0.2%) prescriptions.
  • No significant differences were observed in patient demographics, severity, or 72-hour readmission rates.

Impact:

  • Successfully reduced the administration of non-recommended bronchodilators in pediatric emergency care.
  • Demonstrated a significant decrease in emergency department median attendance time and admission rates.
  • Provides evidence for the effectiveness of systematic, guideline-adherent quality improvement in pediatric respiratory care.