Drug of choice for treatment of type 2 Brittle Asthma is –
Correct Answer: Subcutaneous epinephrine
Description: Ans. is 'd' i.e., Subcutaneous epinephrine o Brittle asthma is a type of asthma distinguishable from other forms by recurrent, severe attacks.o There are two subtypes divided by symptoms: Type 1 and Type 2, depending on the stability of the patient's maximum speed of expiration, or peak expiratory flow rate (PEFR).o Brittle asthma is one of the "unstable" subtypes of "difficult asthma", a term used to characterize the less than 5% of asthma cases that do not respond to maximal inhaled treatment, including high doses of corticosteroids combined with additional therapies such as long-acting beta-2 agonists.o Oxford Textbook of Medicine distinguishes type 1 brittle asthma by# "persistent daily chaotic variability in peak flow (usually greater than 40 per cent diurnal variation in PEFR more than 50 per cent of the time)",o While type 2 is identified by# "sporadic sudden falls in PEFR against a background of usually well-controlled asthma with normal or near normal lung function".o In both types, patients are subject to recurrent, severe attacks.o Individuals with type 1 suffer chronic attacks in spite of ongoing medical therapy, while those with type 2 experience sudden, acute and even potentially life-threatening attacks even though otherwise their asthma seems well managed.
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