All of the following drugs useful in the treatment of a patient with acute bronchial asthma EXCEPT: March 2004
**Core Concept**
Asthma is a chronic inflammatory disease of the airways characterized by recurrent episodes of wheezing, shortness of breath, chest tightness, and coughing. In acute bronchial asthma, the airway inflammation and constriction worsen, requiring prompt treatment to prevent respiratory failure.
**Why the Correct Answer is Right**
In acute bronchial asthma, the primary goal of treatment is to reverse airway constriction, reduce inflammation, and improve lung function. This is achieved through the use of bronchodilators, corticosteroids, and other medications. Among the bronchodilators, beta-2 agonists (e.g., salbutamol) and anticholinergics (e.g., ipratropium) are commonly used. **Option A**, salbutamol, and **Option C**, ipratropium, are examples of effective bronchodilators in asthma treatment.
**Why Each Wrong Option is Incorrect**
**Option B:** Aminophylline is a methylxanthine with some bronchodilatory effects, but its use in acute asthma is limited due to its narrow therapeutic index and potential for toxicity. It is not a preferred initial treatment for acute bronchial asthma.
**Option D:** Ephedrine is a sympathomimetic agent that can cause bronchodilation but is not commonly used in asthma treatment due to its potential for adverse effects, such as tachycardia and hypertension.
**Clinical Pearl / High-Yield Fact**
In acute bronchial asthma, the use of corticosteroids (e.g., prednisolone) is essential to reduce airway inflammation and prevent long-term complications.
**Correct Answer: D. Ephedrine.**