Parainfluenza Virus Medication
- Author: Subhash Chandra Parija, MBBS, MD, PhD, FRCPath; Chief Editor: Burke A Cunha, MD more...
Medication Summary
Ribavirin is a broad-spectrum antiviral agent that has been shown to be effective against HPIV-3 infection in vitro and possibly in vivo. Although results are mixed, ribavirin aerosol or systemic therapy has been used to treat HPIV infections in children and adults who are severely immunocompromised. Use at this time is of uncertain clinical benefit.
Antibiotics are used only if bacterial complications (eg, otitis, sinusitis) develop. Corticosteroids and nebulizers are used to treat respiratory symptoms and to help reduce the inflammation and airway edema of croup.
Corticosteroids
Class Summary
Prednisone, prednisolone, and dexamethasone are commonly used glucocorticoids. Dexamethasone, because of its high potency and prolonged intramuscular half-life, is the preferred anti-inflammatory drug for croup.
Dexamethasone (Decadron, Solurex, Dexasone)
Decreases airway inflammation by inhibiting migration of phagocytes and reversing capillary permeability, thereby reducing edema occurring in croup.
Budesonide inhaled (Pulmicort Respules, Turbuhaler)
Nebulized, this agent is useful to reduce inflammation and edema in patients with croup. Alters level of inflammation in airways by inhibiting multiple types of inflammatory cells and decreasing production of cytokines and other mediators. Turbuhaler is used for adults; Pulmicort Respules is used only for children aged 1-8 y.
Prednisone (Sterapred)
May decrease inflammation by reversing increased capillary permeability and suppressing PMN activity.
Prednisolone (Delta-Cortef, Articulose-50, Econopred)
Decreases inflammation by suppressing migration of PMN leukocytes and reducing capillary permeability.
Sympathomimetics
Class Summary
Epinephrine is highly effective when delivered via nebulizer. Nebulizers are air- or oxygen-powered devices that deliver medications directly to mucosal surfaces of respiratory tract and smooth muscles.
Epinephrine racemic (AsthmaNefrin, microNefrin, S-2)
Racemic epinephrine solution causes alpha-adrenergic receptor–mediated vasoconstriction of edematous tissues, thereby reversing upper airway edema. Provides short-term relief.
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