Adult bronchiolitis medical therapy: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
No edit summary
 
(5 intermediate revisions by the same user not shown)
Line 4: Line 4:


==Overview==
==Overview==
The optimal medical therapy for adult bronchiolitis is unknown. Bronchiolitis is treated based on severity, however, the disease is progressive and inevitably, leads to respiratory failure. Therefore, supportive therapy includes supplemental oxygen, bronchodilators, cough suppressant, anti-reflux therapy, antibiotic macrolides and glucocorticoids.
The optimal medical therapy for adult bronchiolitis is unknown. Therapy is mainly the cessation of exposure to irritant agent. Bronchiolitis is treated based on severity, however, the disease is progressive and inevitably, leads to [[respiratory failure]]. Therefore, supportive therapy includes supplemental [[oxygen]], [[Bronchodilator|bronchodilators]], [[cough suppressant]], anti-reflux therapy, [[Macrolide|macrolides]], [[Immunosuppressive drug|immunosuppressants]] and [[glucocorticoids]]. [[Bronchodilator|Bronchodilators]] and [[glucocorticoids]] have been heavily criticized in their role of improving symptoms, and are reserved only in those who show clinical improvement.


==Medical Therapy==
==Medical Therapy==
*The optimal medical therapy for adult bronchiolitis is unknown.  
*The optimal medical therapy for adult bronchiolitis is unknown.<ref name="pmid15805698">{{cite journal |vauthors=Azuma A, Kudoh S |title=Securing the safety and efficacy of macrolide therapy for chronic small airway diseases |journal=Intern. Med. |volume=44 |issue=3 |pages=167–8 |date=March 2005 |pmid=15805698 |doi= |url=}}</ref><ref name="pmid19210653">{{cite journal |vauthors=Parambil JG, Yi ES, Ryu JH |title=Obstructive bronchiolar disease identified by CT in the non-transplant population: analysis of 29 consecutive cases |journal=Respirology |volume=14 |issue=3 |pages=443–8 |date=April 2009 |pmid=19210653 |doi=10.1111/j.1440-1843.2008.01445.x |url=}}</ref><ref name="pmid15332401">{{cite journal |vauthors=Akpinar-Elci M, Travis WD, Lynch DA, Kreiss K |title=Bronchiolitis obliterans syndrome in popcorn production plant workers |journal=Eur. Respir. J. |volume=24 |issue=2 |pages=298–302 |date=August 2004 |pmid=15332401 |doi= |url=}}</ref>
*Bronchiolitis is treated based on severity, however, the disease is progressive and inevitably, leads to respiratory failure.  
*Therefore, supportive therapy includes supplemental oxygen, bronchodilators, cough suppressant, anti-reflux therapy, antibiotic macrolides and glucocorticoids.


*Therapy is mainly the cessation of exposure to irritant agent.
*Bronchiolitis is treated based on severity, however, the disease is progressive and inevitably, leads to [[respiratory failure]].
*Therefore, supportive therapy includes supplemental [[oxygen]], [[Bronchodilator|bronchodilators]], [[cough suppressant]], anti-reflux therapy, [[Macrolide|macrolides]], [[Immunosuppressive drug|immunosuppressants]] and [[glucocorticoids]].
*[[Bronchodilator|Bronchodilators]] and [[glucocorticoids]] have been heavily criticized in their role of improving symptoms, and are reserved only in those who show clinical improvement.


===Disease Name===
=== Adult bronchiolitis ===
 
* '''1 Stage 1 - Respiratory compromise'''
* '''1 Stage 1 - Name of stage'''
** 1.1 '''Supplemental oxygen'''
** 1.1 '''Specific Organ system involved 1'''
*** 1.1.1 '''Adult'''
*** 1.1.1 '''Adult'''
**** Preferred regimen (1): [[drug name]] 100 mg PO q12h for 10-21 days '''(Contraindications/specific instructions)''' 
**** Preferred regimen (1): [[drug name|maintain oxygen saturation at higher than 90% for 24 hours on standard flow rate]]  
**** Preferred regimen (2): [[drug name]] 500 mg PO q8h for 14-21 days
**** Preferred regimen (2): [[drug name|maintain oxygen saturation at higher than 90% for 20 hours on high flow humidified oxygen]]
**** Preferred regimen (3): [[drug name]] 500 mg q12h for 14-21 days
**** Preferred regimen (3): [[drug name|maintain oxygen saturation at higher than 90% for 24 hours using Heliox (20 - 30% oxygen and 70 - 80% helium)]]  
**** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days 
** 1.2 '''Antibiotic macrolide'''
**** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
*** 1.1.2 Adult
**** Alternative regimen (3): [[drug name]] 500 mg PO q6h for 14–21 days
**** Preferred regimen (1): [[Erythromycin]] 200 - 600mg PO per day   
*** 1.1.2 '''Pediatric'''
**** Preferred regimen (2): [[Clarithromycin]] 250 - 500mg PO per day
**** 1.1.2.1 (Specific population e.g. '''children < 8 years of age''')
***1.1.3 Bronchiolitis obliterans syndrome
***** Preferred regimen (1): [[drug name]] 50 mg/kg PO per day q8h (maximum, 500 mg per dose)  
**** Preferred regimen (1): [[Azithromycin]] 250 mg daily for 5 days followed by 250 mg 3 times a week
***** Preferred regimen (2): [[drug name]] 30 mg/kg PO per day in 2 divided doses (maximum, 500 mg per dose)
***** Alternative regimen (1): [[drug name]]10 mg/kg PO q6h (maximum, 500 mg per day)
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h (maximum, 500 mg per dose)
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h (maximum, 500 mg per dose)
****1.1.2.2 (Specific population e.g. ''''''children < 8 years of age'''''')
***** Preferred regimen (1): [[drug name]] 4 mg/kg/day PO q12h（maximum, 100 mg per dose）
***** Alternative regimen (1): [[drug name]] 10 mg/kg PO q6h (maximum, 500 mg per day)
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h (maximum, 500 mg per dose) 
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h (maximum, 500 mg per dose)
** 1.2 '''Specific Organ system involved 2'''
*** 1.2.1 '''Adult'''
**** Preferred regimen (1): [[drug name]] 500 mg PO q8h
*** 1.2.2  '''Pediatric'''
**** Preferred regimen (1): [[drug name]] 50 mg/kg/day PO q8h (maximum, 500 mg per dose)


* 2 '''Stage 2 - Name of stage'''
** 2.1 '''Specific Organ system involved 1 '''
**: '''Note (1):'''
**: '''Note (2)''':
**: '''Note (3):'''
*** 2.1.1 '''Adult'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 2 g IV q24h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 2 g IV q8h for 14 (14–21) days
***** Alternative regimen (2): [[drug name]] 18–24 MU/day IV q4h for 14 (14–21) days
**** Oral regimen
***** Preferred regimen (1): [[drug name]] 500 mg PO q8h for 14 (14–21) days
***** Preferred regimen (2): [[drug name]] 100 mg PO q12h for 14 (14–21) days
***** Preferred regimen (3): [[drug name]] 500 mg PO q12h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days 
***** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
***** Alternative regimen (3):[[drug name]] 500 mg PO q6h for 14–21 days
*** 2.1.2 '''Pediatric'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
***** Alternative regimen (1): [[drug name]] 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
***** Alternative regimen (2):  [[drug name]] 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day) ''''''(Contraindications/specific instructions)''''''
**** Oral regimen
***** Preferred regimen (1):  [[drug name]] 50 mg/kg/day PO q8h for 14 (14–21) days  (maximum, 500 mg per dose)
***** Preferred regimen (2): [[drug name]] '''(for children aged ≥ 8 years)''' 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
***** Preferred regimen (3): [[drug name]] 30 mg/kg/day PO q12h for 14 (14–21) days  (maximum, 500 mg per dose)
***** Alternative regimen (1):  [[drug name]] 10 mg/kg PO q6h 7–10 days  (maximum, 500 mg per day)
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h for 14–21 days  (maximum, 500 mg per dose)
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h for 14–21 days  (maximum,500 mg per dose)
** 2.2  '<nowiki/>'''''Other Organ system involved 2''''''
**: '''Note (1):'''
**: '''Note (2)''':
**: '''Note (3):'''
*** 2.2.1 '''Adult'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 2 g IV q24h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 2 g IV q8h for 14 (14–21) days
***** Alternative regimen (2): [[drug name]] 18–24 MU/day IV q4h for 14 (14–21) days
**** Oral regimen
***** Preferred regimen (1): [[drug name]] 500 mg PO q8h for 14 (14–21) days
***** Preferred regimen (2): [[drug name]] 100 mg PO q12h for 14 (14–21) days
***** Preferred regimen (3): [[drug name]] 500 mg PO q12h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days 
***** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
***** Alternative regimen (3):[[drug name]] 500 mg PO q6h for 14–21 days
*** 2.2.2 '''Pediatric'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
***** Alternative regimen (1): [[drug name]] 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
***** Alternative regimen (2):  [[drug name]] 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day)
**** Oral regimen
***** Preferred regimen (1):  [[drug name]] 50 mg/kg/day PO q8h for 14 (14–21) days  (maximum, 500 mg per dose)
***** Preferred regimen (2): [[drug name]] 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
***** Preferred regimen (3): [[drug name]] 30 mg/kg/day PO q12h for 14 (14–21) days  (maximum, 500 mg per dose)
***** Alternative regimen (1):  [[drug name]] 10 mg/kg PO q6h 7–10 days  (maximum, 500 mg per day)
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h for 14–21 days  (maximum, 500 mg per dose)
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h for 14–21 days  (maximum,500 mg per dose)




Latest revision as of 17:49, 3 March 2018

Adult bronchiolitis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Occupational lung disease from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Adult bronchiolitis medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Adult bronchiolitis medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Adult bronchiolitis medical therapy

CDC on Adult bronchiolitis medical therapy

Adult bronchiolitis medical therapy in the news

Blogs on Adult bronchiolitis medical therapy


Risk calculators and risk factors for Adult bronchiolitis medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

Overview

The optimal medical therapy for adult bronchiolitis is unknown. Therapy is mainly the cessation of exposure to irritant agent. Bronchiolitis is treated based on severity, however, the disease is progressive and inevitably, leads to respiratory failure. Therefore, supportive therapy includes supplemental oxygen, bronchodilators, cough suppressant, anti-reflux therapy, macrolides, immunosuppressants and glucocorticoids. Bronchodilators and glucocorticoids have been heavily criticized in their role of improving symptoms, and are reserved only in those who show clinical improvement.

Medical Therapy

  • The optimal medical therapy for adult bronchiolitis is unknown.[1][2][3]

Adult bronchiolitis


References

  1. ↑ Azuma A, Kudoh S (March 2005). "Securing the safety and efficacy of macrolide therapy for chronic small airway diseases". Intern. Med. 44 (3): 167–8. PMID 15805698.
  2. ↑ Parambil JG, Yi ES, Ryu JH (April 2009). "Obstructive bronchiolar disease identified by CT in the non-transplant population: analysis of 29 consecutive cases". Respirology. 14 (3): 443–8. doi:10.1111/j.1440-1843.2008.01445.x. PMID 19210653.
  3. ↑ Akpinar-Elci M, Travis WD, Lynch DA, Kreiss K (August 2004). "Bronchiolitis obliterans syndrome in popcorn production plant workers". Eur. Respir. J. 24 (2): 298–302. PMID 15332401.
Retrieved from "https://www.wikidoc.org/index.php?title=Adult_bronchiolitis_medical_therapy&oldid=1451157"