Epinephrine for the wheezing of bronchiolitis is like acetaminophen for the
fever of pneumonia.
Both are symptomatic therapies that do not alter the underlying
Think of epinephrine for bronchiolitis as "nose drops for the bronchioles."
So, like Neosynephrine (R) for the congested nose of coryza, there is an
immediate effect that wears off quite rapidly.
Perhaps all of this is fitting since my grandmother's term for bronchiolitis
was "a chest cold."
> -----Original Message-----
> From: jdfisher [SMTP:[log in to unmask]]
> Sent: December 6, 2002 7:02 PM
> To: [log in to unmask]
> Subject: Epi - cursing the darkness
> The studies I have on hand for epi in bronchiolitis are the following:
> Menon K. J Pediatr 1995;126:1004-7.
> Sanchez I et al. J Pediatr 1993:122:145-51. (The famous 'sedate
> bronchiolitics with chloral hydrate and do PFTs study')
> Kristjansson S et al. Arch Dis Child 1993;69:650-654.
> Reijonen T et al. Arch Pediatr Adolesc Med 1995;149:686-692.
> There's lots of data on injectable epi for bronchiolitis from the 70s.
> studying bronchiolitis however, I always
> remember two studies that put it all in perspective:
> Kong XT et al. Treatment of acute bronchiolitis with Chinese herbs. Arch
> Child 1993;68(4):648-71. - Single blinded
> study showed a 25% reduction in the number of days with cough - let's see
> xopinex do that!!
> Wang E. et al. Observer agreement for respiratory signs and oximetry in
> infants hospitalized with lower respiratory
> infections. Am Rev Respir Dis 1992;145:106-109. - Observers assessed four
> clinical signs - the agreement beyond chance for all four
> clinical signs was below 50% (kappas ranged from .25 to .48).
> to wit: how can we agree which drug is best when we can't agree on which
> patient is better?
> Jay Fisher MD
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