The Journal of asthma : official journal of the Association for the Care of Asthma
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The bronchodilating effect of magnesium sulfate (MgSO4) was studied in two patients with status asthmaticus, who were intubated and mechanically ventilated by a respirator. Airway resistance was continuously monitored by the respiration-controlled interruption technique. After administration of 0.5 mmol/min MgSO4 intravenously, airway resistance decreased from 17 to 9, and from 13 to 8 mmHg/L/s in the two patients, respectively, and piping rales diminished or disappeared. We conclude that while corticosteroid therapy requires several hours to demonstrate significant effects in status asthmaticus, MgSO4 is of great benefit in the rapid improvement of airflow obstruction.
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Beta 2 adrenergic agonists, especially in aerosol formulations, are often used as first-line medications for treating the symptoms of bronchial asthma. Although oral forms of these medications may result in greater improvement in small airway function, comparative studies of these two routes of administration show that inhaled beta 2 adrenergic bronchodilators have a more rapid onset of activity, are as long lasting, and as effective in improving pulmonary function as their oral forms. Moreover, they are equally effective at much lower dosages which results in fewer adverse effects. Their use in metered-dose inhalers, nebulizers, and breath-activated devices, is improving asthma therapy.
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We describe a model of asthma self-management based on environmental control of behavior. The model emphasizes aspects of the environment that either prompt or strengthen asthma self-management behavior. ⋯ We describe concepts related to cueing and reinforcement, and how these operations might be incorporated in individualized self-management programs. Finally, we discuss evidence supporting asthma self-management programs based on environmental control behavior.