Which of the following medications is/are used to treat patients who have inhalation injury?
I.Beta-2 agonists
II.Inhaled corticosteroids
III.Racemic epinephrine
IV.N-Acetylcysteine

Question

Quizplus · Accepted Answer

Inhalation injury is best managed with beta-2 agonists,especially in patients who also have preexisting asthma or reactive airway disease.Aerosolized bronchodilators are effective by providing bronchial smooth muscle relaxation and stimulating mucociliary clearance.However,when using these agents,it is important to remember they also increase overall metabolic rates in a patient who is already hypermetabolic secondary to thermal injuries.Racemic epinephrine may be used as an aerosolized vasoconstrictor,bronchodilator,and secretion bond breaker.The vasoconstrictive action of racemic epinephrine is useful in reducing mucosal and submucosal edema within the walls of the pulmonary airways.A secondary bronchodilator action serves to reduce potential spasm of the smooth muscle of the terminal bronchioles.Racemic epinephrine has also been used in the treatment of postextubation stridor.N-Acetylcysteine is a powerful mucolytic agent used in respiratory care.It contains a thiol group,the free sulfhydryl radical of which is a strong reducing agent that ruptures the disulfide bonds that stabilize the mucoprotein network of molecules in mucus.Agents that break down these disulfide bonds produce the most effective mucolysis.N-Acetylcysteine has been proven effective in combination with aerosolized heparin for the treatment of inhalation injury in animal studies.Heparin and N-acetylcysteine combinations have been used as scavengers for the oxygen-free radicals produced when alveolar macrophages are activated,either directly by chemicals in smoke or by one or more compounds in the arachidonic cascade.Animal studies have shown an increased ratio of PaO₂ to FiO₂,decreased peak inspiratory pressures,and a decreased amount of fibrin cast formation with heparin/N-acetylcysteine combinations.Pediatric patients treated with aerosolized heparin/N-acetylcysteine combinations showed a reduction in the incidence of atelectasis,number of ventilator days,incidence of reintubation for progressive respiratory failure,and mortality.

Which of the Following Medications Is/are Used to Treat Patients