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Friday, December 4, 2009

Bronchodilators now treat inflammation too????

Wow! It just never stops folks. I was in the ER when one of our regular asthma patients was having a discussion with the ER doc. What impressed me was what the doc said.

"Well," he said, "I think what you have going on in your lungs right now is inflammation. Soooo, I'm going to give you some steroids and some breathing treatments to help with that."

"Holy...!!!" It almost slipped out, yet somehow I managed to catch myself. I was stunned at this new revelation. I was stunned because I actually heard it. I bet anything he had no idea his humble RT was standing behind him right at that very moment.

We educated folk know that bronchodilators are, well, bronchodilators. They, in essence, dilate bronchioles, which are the air passages in our lungs. Actually, what they do is relax spasming bronchioles when they are spasming. If they are not spasming, they do not dilate lungs.

Likewise, while asthmatic lungs are chronically inflamed, and therefore hypersensitive to one's asthma triggers. Thus, when the asthmatic is exposed to said asthma triggers, the inflamed airways respond by causing the muscles surrounding the bronchi oles to spasm. A bronchodilator, if given, will calm the muscles down and, thus, dilate the air passages.

It must be noted that bronchospasming is a side effect of a greater problem -- which is acute worsening of otherwise chronic inflammation. This inflammation is not treated with bronchodilators, but inhaled or systemic corticosteroids depending on the severity of the inflammation.

So, if doctors believe bronchodilators really do treat inflammation, this explains why bronchodilators are ordered for bronchiolitis which causes inflammation of the bronchioles, and pneumonia, which causes inflammation of the alveoli.

This is interesting. Why does it take so long for physicians to share this wisdom. We'll have to add this new medicine to our Ventolin types list. We'll call this one inflammatonex or inflammatolin.

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