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a spasm of the bronchi that makes exhalation difficult and noisy; associated with asthma and bronchitis

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/07/07 07:56:24」(JST)

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Bronchospasm or a bronchial spasm is a sudden constriction of the muscles in the walls of the bronchioles. It is caused by the release (degranulation) of substances from mast cells or basophils under the influence of anaphylatoxins. It causes difficulty in breathing which can be very mild to severe.

Inflamed airways and bronchoconstriction in asthma. Airways narrowed as a result of the inflammatory response cause wheezing.

Bronchospasms appear as the feature of asthma, chronic bronchitis, anaphylaxis, as a possible side effect of the drug pilocarpine (which is used to treat illness resulting from the ingestion of deadly nightshade as well as other things) and also as a side effect for beta blockers (used to treat hypertension) and other drugs. It can present as a sign of giardiasis.

Bronchospasms are one of several conditions associated with cold housing.^[1]

Some of the things that can cause bronchospasms are consuming foods, taking medicines, getting insect bites or stings when one is allergic to them, and fluctuating hormone levels, particularly in women.^[2]^[3]

A few of the more common allergens are foods such as eggs, milk, peanuts, walnuts, tree and other nuts, fish, especially shellfish, soy and wheat; insect bites and stings, especially bee stings; and other medicines, especially penicillin and its derivatives.

The overactivity of the bronchioles' muscle is a result of exposure to a stimulus which under normal circumstances would cause little or no response. The resulting constriction and inflammation causes a narrowing of the airways and an increase in mucus production; this reduces the amount of oxygen that is available to the individual causing breathlessness, coughing and hypoxia.

Bronchospasms are a serious potential complication of placing a breathing tube during general anesthesia. When the airways spasm or constrict in response to the irritating stimulus of the breathing tube, it is difficult to maintain the airway and the patient can become apneic.

Cause

Bronchospasm are caused by a number of reasons. Lower respiratory tract diseases such as Pneumonia, Asthma, Chronic Obstructive Pulmonary Disease (COPD), and Emphysema can result in contraction of the airways. Other causes are side effects of topical decongestants such as Oxymetazoline and Phenylephrine. Both of these medications activate Alpha 1 adrenergic receptors that result in smooth muscle constriction. Non-selective Beta blockers are known to cause bronchospasm as well. Beta blockers bind into the β2 receptors and block the action of Epinephrine and Norepinephrine from binding to its receptors, causing shortness of breath.

Treatment

Beta 2 adrenergic agonists are recommended for bronchospasm.

Short acting (SABA)
- Salbutamol
- Levosalbutamol
Long acting (LABA)
- Formoterol
- Salmeterol
Others
- Dopamine
- Norepinephrine
- Epinephrine

Muscarinic Acetylcholine receptor antagonist

See also: Parasympathetic nervous system and Sympathetic nervous system

Since the neurotransmitter, acetylcholine, is known to decrease sympathetic response by slowing the heart rate and constricting the smooth muscle tissue; ongoing research and successful clinical trials have shown that agents such as diphenhydramine, atropine and Ipratropium bromide is known to be effective for treating asthma and COPD-related symptoms.

References

^ Marsh, Alex; Gordon, David; Heslop, Pauline; Pantazis, Christina (2000). "Housing Deprivation and Health: A Longitudinal Analysis". Housing Studies 15 (3): 411. DOI:10.1080/02673030050009258.
^ Haggerty, Catherine L.; Ness, Roberta B.; Kelsey, Sheryl; Waterer, Grant W. (2003). "The impact of estrogen and progesterone on asthma". Annals of Allergy, Asthma & Immunology 90 (3): 284. DOI:10.1016/S1081-1206(10)61794-2.
^ Hatfield. "Asthma in Women". http://www.webmd.com/asthma/features/asthma-women.

UpToDate Contents

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1. 成人における喘息以外の喘鳴をきたす疾患の評価 evaluation of wheezing illnesses other than asthma in adults
2. 小児の喘鳴へのアプローチ approach to wheezing in children
3. ウイルス誘発性の喘鳴および喘息：概要 virus induced wheezing and asthma an overview
4. 小児における喘息以外の喘鳴疾患 wheezing illnesses other than asthma in children
5. 幼児における再発するウイルス誘発性喘鳴の治療 treatment of recurrent virus induced wheezing in young children

English Journal

Pulmonary toxicities from targeted therapies: a review.

Barber NA, Ganti AK.SourceDivision of Hematology/Oncology, Department of Internal Medicine, University of Nebraska Medical Center, 987680 Nebraska Medical Center, Omaha, NE, 68198-7680, USA.
Targeted oncology.Target Oncol.2011 Nov 11. [Epub ahead of print]
Pulmonary toxicity is rarely seen with most commonly used targeted therapies. The endothelial growth factor receptor (EGFR) small-molecule tyrosine kinase inhibitors (TKIs) gefitinib and erlotinib can cause interstitial lung disease (ILD). BCR-ABL tyrosine kinase inhibitors imatinib and dasatinib ca
PMID 22076388

Bronchial Thermoplasty for Severe Asthma.

Wahidi MM, Kraft M.SourceInternal Medicine, Pulmonary and Critical Care, Duke University Medical Center, Durham, North Carolina, United States.
American journal of respiratory and critical care medicine.Am J Respir Crit Care Med.2011 Nov 10. [Epub ahead of print]
Bronchial thermoplasty (BT) is a novel treatment of patients with severe asthma who continue to be symptomatic despite maximal medical treatment. It aims to reduce the smooth muscle mass in the airways by delivering controlled thermal energy to the airway walls during a series of three bronchoscopie
PMID 22077066

Japanese Journal

Unilateral bronchospasm during microcatheter manipulation in an interventional neuroradiology suite

REDDY Kiran,PRABHAKAR Hemanshu,YADAV Naveen,SINGH Gyaninder Pal,ALI Zulfiqar
Journal of anesthesia 24(2), 313-314, 2010-04-20
NAID 10027266780

気管支痙攣を発症しPCPS導入に至った胸部外傷の1例

細見早苗,伊藤賀敏,小林誠人,甲斐達朗
日本救急医学会雑誌 21(1), 35-41, 2010-01-15
NAID 10027836367

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