Which medication is NOT useful in the immediate management of status asthmaticus?

Which medication is NOT useful in the immediate management of status asthmaticus?

• A. Terbutaline
• B. Subcutaneous epinephrine
• C. Magnesium sulfate
• D. Cromolyn

Answer: (D)

Immediate management of status asthmaticus requires rapid-acting bronchodilation and agents that quickly reduce airway constriction and edema. Terbutaline and epinephrine provide fast bronchodilation through beta-2 receptor stimulation (and epinephrine also adds vasoconstriction to reduce swelling), and magnesium sulfate helps relax bronchial smooth muscle when given in the acute setting. Cromolyn, on the other hand, is a mast cell stabilizer used for prevention; it works by inhibiting mediator release but has no rapid bronchodilatory effect and its onset is not suitable for an acute crisis. Because it does not reverse established bronchospasm, cromolyn is not useful for the immediate management of status asthmaticus.

Immediate management of status asthmaticus requires rapid-acting bronchodilation and agents that quickly reduce airway constriction and edema. Terbutaline and epinephrine provide fast bronchodilation through beta-2 receptor stimulation (and epinephrine also adds vasoconstriction to reduce swelling), and magnesium sulfate helps relax bronchial smooth muscle when given in the acute setting. Cromolyn, on the other hand, is a mast cell stabilizer used for prevention; it works by inhibiting mediator release but has no rapid bronchodilatory effect and its onset is not suitable for an acute crisis. Because it does not reverse established bronchospasm, cromolyn is not useful for the immediate management of status asthmaticus.