Bronchial Thermoplasty Medication

Updated: Dec 15, 2015
  • Author: Said A Chaaban, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
  • Print
Medication

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and prevent complications.

Next:

Corticosteroids

Class Summary

Corticosteroids have anti-inflammatory properties and cause profound and varied metabolic effects. They modify the body’s immune response to diverse stimuli.

Prednisone

Prednisone may decrease inflammation by reversing increased capillary permeability and suppressing PMN activity. It may also cause profound and varied metabolic effects, particularly in relation to salt, water, and glucose tolerance, in addition to their modification of the immune response of the body.

Prednisolone (Orapred, Pediapred, Millipred)

Corticosteroids act as potent inhibitors of inflammation; they may decrease inflammation by reversing increased capillary permeability and suppressing PMN activity. They may also cause profound and varied metabolic effects, particularly in relation to salt, water, and glucose tolerance, in addition to their modification of the immune response of the body.

Previous
Next:

Anxiolytics, Benzodiazepines

Class Summary

In the operating room, intravenous (IV) administration of a small dose of midazolam before arterial line insertion can reduce anxiety, tachycardia, and hypertension.

Midazolam

Midazolam is a shorter-acting benzodiazepine sedative-hypnotic that is useful in patients who require acute and/or short-term sedation. Midazolam is also useful for its amnestic effects.

Previous
Next:

Opioid Analgesics

Class Summary

Induction of anesthesia is accomplished by using high doses of opioid. Pain control is essential to quality patient care. Analgesics ensure patient comfort, promote pulmonary toilet, and have sedating properties that are beneficial for patients who experience pain.

Fentanyl citrate (Duragesic, Abstral, Actiq, Fentora, Onsolis)

Fentanyl citrate is a synthetic opioid that is 75-200 times more potent than morphine sulfate and that has a much shorter half-life. It has less hypotensive effects and is safer in patients with hyperactive airway disease than morphine because of minimal-to-no associated histamine release.

The parenteral form is the DOC for conscious sedation analgesia. It is ideal for analgesic action of short duration during anesthesia and in the immediate postoperative period.

Fentanyl citrate is an excellent choice for short-duration (30-60 minutes) pain management and sedation and easy to titrate. It is easily and quickly reversed by naloxone.

After the initial parenteral dose, subsequent parenteral doses should not be titrated more frequently than q3h or q6h thereafter.

Morphine sulfate (Duramorph, Astramorph, MS Contin, Avinza, Kadian)

Morphine sulfate is the DOC for analgesia owing to its reliable and predictable effects, safety profile, and ease of reversibility with naloxone.

Various IV doses are used; it is commonly titrated until the desired effect is obtained.

Previous
Next:

Local Anesthetics, Amides

Class Summary

Local anesthetics block the initiation and conduction of nerve impulses. Anesthetics used for the procedure include lidocaine.

Lidocaine and epinephrine (Xylocaine MPF with epinephrine)

Lidocaine is an amide local anesthetic used in 1%-2% concentration. It inhibits depolarization of type C sensory neurons by blocking sodium channels.

Epinephrine prolongs its effect and enhances hemostasis (maximum epinephrine dose, 4.5-7 mg/kg).

Previous