Is Adrenaline Nebulizer Safe in Acute Bronchiolitis

4th Pediatric Infectious Diseases Conference

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katihar...

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	Specialist Answers
Question
Is adrenaline nebulizer safe and effective in cases of acute bronchiolitis? What is its dose and dilution? How frequently it may be repeated? Is it preferred over solbutamol?
Answer
Adrenaline has many theoretical advantages over salbutamol. It can decongest mucosa with alpha-adrenergic vasoconstrictor action and this may in addition lead to decreased systemic absorption resulting in less tachycardia than salbutamol. With beta 2 adrenergic effect smooth muscle relaxation occurs and anti-histamine effect results in decreased edema and reduced catarrahal secretions. Studies comparing the two drugs are almost unanimous in showing adrenaline better than salbutamol. Dose used is 0.1 ml/kg body weight of 1 in 10,000 solution of adrenaline. Ref: Reijonen K, Korppi M, Pitkakangas S et al. The clinical efficacy of nebulized racemic epfinerine and albutermol in acute bronchiolitis. Arch Pediatric Adolsec Med 1995; 149: 686-692 Menon S, Sutcliffe T, Klassen TP. A randomized controlled trial comparing the efficacy of adrenaline with salbutamol in the treatment of acute bronchiolitis. J Pediatr 1993; 122: 145-151 Bertand P, Aranibar H, Castro E et al. Efficacy of nebuized adrenaline versus salbutamol in hospitalized infants with bronchiolitis. Pediatr Pulmonol 2001; 31: 284-288. Ray MS, Singh V. Comparison of nebulised adrenaline versus salbutamol in wheeze associated infants. Indian Pediatric 2002;39: 12-22. Back to All Questions

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