Bronchial Obstruction in Children

• Anticholinergic drugs 
block the muscarinic cholino-receptors for 
acetylcholine. Bronchodilator effect of Ipratropii bromidum (Atrovent) 
develops through 15-20 minutes after inhalation.
 
• Through a spacer 2 doses (40 mg) of the drug are inhaled once, via a 
nebulizer - 8-20 drops (100-250mkg) 3-4 times a day. 
• In the complex treatment of BOS a combined preparation "Berodual" is 
most commonly used; it combines two mechanisms of action: stimulation 
of 
β
2-adrenergic receptors and M-cholinergic receptors blockade. 
• Berodual contains Ipratropii bromidum and Fenoterolum. The best way is a 
nebulizer drug delivery. 
• Single dose for children up to 5 years old is on average 1 drop / kg 3-4 
times a day. 

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• Short-acting theophyllines 
are now usually referred 
to the preparations of the second stage and are 
administered at the lack of effectiveness of short-
acting 
β
2- agonists and M-anticholinergics.
 
• In severe obstruction eufillin 2.4% is prescribed drip-
feed in saline solution in a daily dose of 16-18mg / 
kg, divided into 4 injections.

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Anti-inflammatory therapy
• For the treatment of severe BOS ICS (Dexamethasone and Budesonide 
"Pulmicort") are used. Beginning with 6 months of age they are 
administered by inhalation through a nebulizer in a daily dose of 0.25-1 mg 
/ day (the amount of inhaled solution is adjusted to 2-4 ml by saline 
solution). The drug is administered 2 to 4 times a day 15-20 minutes after 
inhalation of bronchodilators. 
• The duration of ICS therapy depends on the nature of the disease, duration 
and severity of obstruction, as well as the effect of the therapy. 
• In children with acute obstructive bronchitis with severe bronchial 
obstruction, duration of treatment is usually 5-7 days, and in children with 
croup - 2-3 days. 

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