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Date of Graduation
Capstone Project (On-Campus Access Only)
Master of Science in Physician Assistant Studies
Judy Ortiz, MS PA-C
Jonathon W. Gietzen MS PA-C
Background. There has been an evolution in the treatment of acute bronchitic symptoms in the past 30 years. Theophylline was the method of choice at one time, but more recent introductions of beta-2 adrenergic compounds (Albuterol) and anticholinergic compounds (Ipratropium), short-term treatment is intriguing and used by many clinicians.
Methods. This article reviews current clinical studies to arrive at a consensus on the treatment of acute symptoms of bronchitis with Albuterol, Ipratropium/Atrovent and these two drugs in combination. The paper reviews work from clinical publications which primarily involves adults with primary bronchitis or acute bronchitic symptoms related to underlying disease. '
Conclusions. The paper concludes that the. use of Albuterol and/or Ipratropium is not advised for the treatment of acute symptoms of bronchiolitis, particularly that caused by Respiratory Syncytial Virus. The paper does conclude that treatment with Albuterol and/or Ipratropium may be useful in some adult patients with acute bronchitis who mayor may not have underlying chronic lung disease, but not in most acute cases. The meta-analysis by Smucny does report that patients with wheezing symptoms may greatly benefit from a combination regiment of bronchodilators. But with treating the cough, there is compelling evidence against routine bronchodilators.6 It is evident that the PCP (primary care provider) must carefully and meticulously examine the patient and try to distinguish what exactly are the symptoms involved. One may find themselves treating the situation differently if they were to find wheezing and coughing upon exam. It is intuitively obvious that more research is needed in these areas in order to fully demonstrate effectiveness of multiple therapy regiments on healthy adults without underlying lung disease in acute bronchitis. Ultimately, the overall consensus among researches is that more intermediate-sized blinded controlled studies are needed to prove or disprove the benefit of using bronchodilator combination therapy in treating acute bronchitis without underlying lung disease.
Hypothesis: I set out to explore and research if Albuterol and Atrovent used in combination and individually could actually benefit the patient who has been diagnosed with acute bronchitis without underlying lung disease.
Green, Shane C., "The Efficacy of Bronchodilators-Albuterol and Ipratropium/Atrovent in Treating Symptoms such as Wheezing in Acute Bronchitis in Adults Without Underlying Lung Disease" (2007). School of Physician Assistant Studies. 21.