McFadden E R
Asthma and Allergic Disease Center, Cleveland, Ohio.
N Engl Reg Allergy Proc. 1987 Sep-Oct;8(5):301-4. doi: 10.2500/108854187779023479.
The therapeutic aims in the treatment of severe asthma are to relieve bronchospasm, mobilize secretions and maintain alveolar ventilation. In emergency situations, adrenergic agonists by aerosol are the drugs of choice because of their speed of onset and potency. Intravenous aminophylline produces much less effect and data are accumulating that suggest that for most patients combined therapy with methylxanthines and sympathomimetics may not produce a greater response over that seen with sympathomimetics alone. Anticholinergics may be useful adjuncts, but their rate of onset is too slow to be used as first time therapy.
重症哮喘的治疗目标是缓解支气管痉挛、促进分泌物排出并维持肺泡通气。在紧急情况下,吸入型肾上腺素能激动剂是首选药物,因为其起效迅速且效力强大。静脉注射氨茶碱的效果要差得多,而且越来越多的数据表明,对于大多数患者而言,甲基黄嘌呤类药物与拟交感神经药联合使用可能不会比单独使用拟交感神经药产生更大的反应。抗胆碱能药物可能是有用的辅助药物,但其起效速度太慢,不能用作初始治疗。