Section B5However, If you are of the belief that bronchodilator therapy will not unstiffen fibrotic parenchemal tissue in the lungs of pulmonary fibrosis patients, then you should not recommend bronchodilator therapy for home use. However, if the patient presents to the emergency room, bronchodilator therapy should be initiated immediately.
Dyspnea alone is indication enough for bronchodilator therapy. However, if you want to get creative, you may consider treating overlying condition, such as pulmonary edema or pneumonia. The interesting thing, however, is both edema and pneumonia are treated the same as any other pulmonary condition -- with aerosolized bronchodilators.
If the patient questions why she needs aerosolized bronchodilator therapy to treat dyspnea when admitted in the hospital yet not to treat dypsnea at home, you should repeat the following line:
"Your pulmonary fibrosis doesn't look any worse on x-ray. What we do see is water on your lungs or an infection, and a bronchodilator will help with that."Any further questions see page 80.