PAEA Surgery End Of Rotation (EOR) Practice Exam

If bronchospasm is not relieved with epinephrine, which medication can be used next?

1. Atropine

2. Albuterol

3. Montelukast

4. Saline nebulizer

The correct answer is: Albuterol

When bronchospasm is not alleviated by epinephrine, the next appropriate step in treatment is to use albuterol, which is a short-acting beta-2 adrenergic agonist. Albuterol functions by relaxing bronchial smooth muscle, leading to bronchodilation. It is commonly used in the management of asthma and other conditions characterized by bronchospasm. The mechanism of action of albuterol is specifically designed to target beta-2 receptors in the lungs, resulting in a rapid onset of action and providing quick relief from bronchospasm symptoms. Its effectiveness in acute situations makes it a first-line treatment after epinephrine if symptoms persist. While other medications listed may have roles in the management of respiratory issues, they are not the best immediate alternatives after epinephrine in the case of bronchospasm that has not responded. For example, atropine is more often used for bradycardia rather than bronchospasm, montelukast is a leukotriene receptor antagonist that is used for long-term control, and saline nebulizers typically provide moisture but do not have bronchodilating properties. Therefore, the selection of albuterol as the next line of treatment is appropriate given its rapid action and specific mechanism for relieving bronchosp