> -----Original Message-----
> From: [log in to unmask] [mailto:[log in to unmask]]
> Sent: Monday, December 11, 2000 4:26 PM
> To: Dunn Matthew Dr. ACCIDENT & EMERGENCY - SwarkHosp-TR
> Subject: Re: Re: Asthma - Resusitation
>
>
> I think we are in agreement.
>
> The point I was trying to get across is that there is quite
> a lot of literature out there (I agree with your comments
> on aminophylline - though many of the studies are not
> in true acute SEVERE asthma). There is not a lot of data
> on the effects of polypharmacy. Most trials look at one
> new drug (which is fair enough), how they work in
> combination is unknown - there may for instance be
> little benefit in adding multiple IV bronchodilators - yet
> the side effects may be added. We just don't know.
>
> Could you forward this to the list as I cannot from this
> PC - thanks
>
> Simon
>
> >Simon Carley wrote:
> >>How many asthmatics are we going to use, steroids,
> B2 agonists, atrovent,
> >aminophylline, halothane, lignocaine, ketamine,
> magnesium and heliox in all
> >at the same time!
> >
> >The Cochrane review of aminophylline has been
> published now- showed no
> >benefit and significant side effects. Polypharmacy with
> arrythmogenic
> >agents? Magnesium has good evidence in the
> Cochrane review (albeit in a
> >different group of patients and with the end point of
> admission or
> >discharge), but seems pretty safe. I certainly wouldn't
> call it
> >'unconventional' any more. If you're intubating the
> patient, I was brought
> >up to believe that paralysis helps (seems reasonable,
> by increasing chest
> >wall conpliance- not seen any studies, though- is this
> still common
> >practice?)
> >
> >Matt Dunn
> >
> >
>
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