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Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Asthma is an airway obstruction which is reversible, either spontaneously or in response to treatment. Repeated peak expiratory flow rate (PEFR) measurements, up to six times daily, allows this characteristic reversibility to be recognised, to guide diagnosis and therapy. Chronic asthmatics may eventually become relatively irreversible, and then appear similar to chronic bronchitics - unless an adequate history is taken. The commonest world-wide allergen is the fecal pellet of the house mite. Modern therapy of asthma starts with inhaled beta 2 agonists, but difficulty in using metered dose inhalers is helped by the 'spacer', or reservoirs (e.g. 'Nebuhaler'). Interaction between slow-release oral theophyllines and beta 2 agonists by inhalation maximises bronchodilatation but minimises tremor. High-dose ipratropium inhalation, as isotonic wet nebulisation with a beta 2 agonist, is useful in acute severe asthma. High doses of inhaled topical steroid are valuable in the difficult asthmatic, but pituitary adrenal suppression occurs if dosage exceeds 1,500 micrograms/day. Cromoglycate and a beta 2 agonist by inhalation can prevent exercise-induced asthma. Long-term oral steroids (never over 10 mg/day) are only used if inhaled therapy (+/- oral slow-release theophyllines) fails. Acute severe asthma needs parenteral steroid, parenteral beta 2 agonist, high-dose beta 2 agonist by inhalation, oxygen and hospital admission. Ventilation is increased in the acute severe asthmatic with hypoxia and low PCO2. In 90 asthmatic deaths surveyed in Britain, half had failed to realise the severity.
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PMID:Reversible airway obstruction: neurohumoral mechanisms and treatment. Lecture on asthma: clinical overview. 288 69

We investigated the efficacy and side effects of "low-dose isoproterenol continuous nebulization" for childhood status asthmaticus, and compared them with those of "high-dose method". "Low-dose" is defined as 10 ml or less of 0.5% dl-isoproterenol solution diluted in 500 ml of normal saline. Subjects were 23 children who were hospitalized and underwent the nebulization therapy. The period of continuous nebulization was 26.3 +/- 12.5 hours. The Wood's clinical score clearly decreased in 22 cases, the average score changing from 7.3 +/- 1.2 to 2.8 +/- 1.5. Heart rate was not elevated significantly during the nebulization period, and decreased gradually (142 +/- 22/min at the start of the nebulization, 145 +/- 22/min at 1 hour, and 134 +/- 23/min at 3 hours, and 103 +/- 13/min at the cessation of the nebulization). Serum GOT, LDH, CPK, and potassium were decreased after the nebulization compared with the values before the treatment, the changes of the last 2 items being statistically significant. Two subjects who had vomited before the nebulization therapy complained nausea during the procedure, and one experienced transient finger tremor. We conclude that "low-dose isoproterenol continuous nebulization" is an effective and safe method for childhood status asthmaticus. We expect that this method will be familiar to all clinicians.
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PMID:[Isoproterenol continuous nebulization of childhood status asthmaticus. II. Efficacy and side effects of low-dose method comparing with high-dose method]. 972 48