Which medications in the drug class Nebulized Vasoconstrictors are used in the treatment of Croup?

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

Epinephrine stimulates alpha receptors and beta2 receptors. It constricts the precapillary arterioles, thus decreasing airway edema. Because of the potential adverse effects of tachycardia and hypertension, it is reserved for children with moderate to severe disease.

The effects of epinephrine are transient, and most trials show alleviation of symptoms for no longer than 2 hours. In the 1980s and early 1990s, a rebound phenomenon was thought to occur, necessitating admission of all children who received the drug. However, patient discharge after 3-4 hours of observation has since become acceptable, as long as the patient has no stridor at rest, normal air entry, normal color, and normal consciousness and has received a dose of steroids.

Epinephrine (Adrenalin)

This agent is a levo isomer. It stimulates alpha-, beta1-, and beta2-adrenergic receptors, which results in bronchodilatation, increased peripheral vascular resistance, hypertension, increased chronotropic cardiac activity, and positive inotropic effects. Epinephrine causes alpha-adrenergic receptor–mediated vasoconstriction of edematous tissues, thus reversing upper airway edema.

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