Which medications are typically reserved for croup in patients with moderate to severe respiratory distress?

Updated: Oct 09, 2019
  • Author: Germaine L Defendi, MD, MS, FAAP; Chief Editor: Russell W Steele, MD  more...
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Answer

Nebulized racemic epinephrine (mixture of dextro isomers and levo isomers) or L-epinephrine is typically reserved for patients in moderate to severe distress. Epinephrine constricts the precapillary arterioles through adrenergic stimulation, thereby decreasing capillary hydrostatic pressure. This leads to fluid resorption from the interstitium and improves the laryngeal mucosal edema. Because of the potential adverse effects of tachycardia and hypertension, it is reserved for children with moderate to severe disease. [23]


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