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| {{CMG}}; {{AE}} [[Prashanth Saddala M.B.B.S.]]; Areej Tariq | | {{CMG}}; {{AE}} [[Prashanth Saddala M.B.B.S.]]; Areej Tariq |
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| == Overview == | | ==[[Bronchospasm overview|Overview]]== |
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| '''Bronchospasm''' is a difficulty in breathing caused by a sudden constriction of the muscles in the walls of the bronchioles.
| | ==[[Bronchospasm historical perspective|Historical Perspective]]== |
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| ==Pathophysiology== | | ==[[Bronchospasm classification|Classification]]== |
| Bronchospasm is caused by the release ([[degranulation]]) of substances from [[mast cells]] or [[basophil]]s under the influence of [[anaphylatoxin]]s. The overactivity of the bronchioles' muscle is a result of exposure to a stimulus which under normal circumstances would cause little or no response. The resulting constriction and inflammation causes a narrowing of the airways and an increase in [[mucus]] production; this reduces the amount of [[oxygen]] that is available to the individual causing breathlessness, coughing and [[hypoxia (medical)|hypoxia]].
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| [[Image:Bb.png|thumb|center|470px|'''Inflamed airways and bronchoconstriction in asthma'''. Airways narrowed as a result of the inflammatory response cause wheezing.]] | | ==[[Bronchospasm pathophysiology|Pathophysiology]]== |
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| == Causes == | | ==[[Bronchospasm causes|Causes]]== |
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| === Common Causes === | | ==[[Bronchospasm differential diagnosis|Differentiating Bronchospasm from other Diseases]]== |
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| *[[Allergens]] such as eggs, milk, [[peanut allergy|peanuts]], [[peanut allergy|walnuts]], tree and other [[peanut allergy|nuts]], fish, especially [[shellfish allergy|shellfish]], soy and wheat; insect bites and stings, especially [[bee stings]]; and other medicines, especially [[penicillin]] and its derivatives.
| | ==[[Bronchospasm epidemiology and demographics|Epidemiology and Demographics]]== |
| *[[Anaphylaxis]]
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| *[[Asthma]]
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| *[[Beta-blockers]]
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| *[[Bronchitis]]
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| *Cold air <ref>{{cite journal |doi=10.1080/02673030050009258 |title=Housing Deprivation and Health: A Longitudinal Analysis |year=2000 |last1=Marsh |first1=Alex |last2=Gordon |first2=David |last3=Heslop |first3=Pauline |last4=Pantazis |first4=Christina |journal=Housing Studies |volume=15 |issue=3 |pages=411}}</ref>
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| *[[COPD]]
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| *[[Decongestants]]
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| *[[Endotracheal tube]] placement
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| *[[LRTI]]
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| *[[URTI]]
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| === Causes by Organ System === | | ==[[Bronchospasm risk factors|Risk Factors]]== |
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| {|style="width:80%; height:100px" border="1"
| | ==[[Bronchospasm natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
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| |style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Churg-Strauss syndrome]], [[Anaphylactic shock]]
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| |- | |
| |-bgcolor="LightSteelBlue"
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| | '''Chemical / poisoning'''
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| |bgcolor="Beige"| [[5-Hydroxyindoleacetic acid]], [[Alanycarb]], [[Aldicarb]], [[Aldoxycarb]], [[Allyxycarb]], [[Amidithion]], [[Aminocarb]], [[Amiton]], [[Anaphylatoxin]], [[Athyl-Gusathion]], [[Azinfosethyl]], [[Azinfos-methyl]], [[Azinophos-methyl]], [[Azinphos]], [[Azinphos-ethyl]], [[Azinphos-methyl]], [[Azinphosmetile]], [[Azothoate]], [[Bendiocarb]], [[Benfuracarb]], [[Benoxafos]], [[Bromophos]], [[Bromophos-ethyl]], [[Snake bite]], [[Bufencarb]], [[Butacarb]], [[Butocarboxim]], [[Butoxcarboxim]], [[Cadusafos]], [[Carbamates]], [[Carbaryl]], [[Carbofuran]], [[Carbophenothion]], [[Carbosulfan]], [[Caterpillar poisoning]], [[Chlorfenvinphos]], [[Chlorine Dioxide]], [[Chloroacetophenone]], [[Chlorobenzylidene Malononitrile]], [[Chloropyrifos]], [[Chlorpyrifos methyl]], [[Cloethocarb]], [[CS gas]], [[Cyanthoate]], [[Decarbofuran]], [[Demeton]], [[Demeton-methyl]], [[Demeton-O]], [[Demeton-O-methyl]], [[Demeton-S-methyl]], [[Demeton-S-methylsulphon]], [[Dialifos]], [[Diazinon]], [[Dichlorvos]], [[Dicresyl]], [[Dicrotophos]], [[Dimetan]], [[Dimethoate]], [[Dimetilan]], [[Dioxacarb]], [[Dioxathion]], [[Disulfoton]], [[EMPC]], [[Endothion]], [[Ethiofencarb]], [[Ethion]], [[Ethoate-methyl]], [[Ethoprophos]], [[Ethyl-guthion]], [[Etrimfos]], [[Eucalyptus oil ]], [[Fenchlorphos]], [[Fenethacarb]], [[Fenitrothion]], [[Fenobucarb]], [[Fensulfothion]], [[Fenthion]], [[Fonophos]], [[Formothion]], [[Furathiocarb]], [[Gonionemus poisoning]], [[Guthion (ethyl)]], [[Heptenophos]], [[Hydrogen sulfide]], [[Hyquincarb]], [[Iodofenphos]], [[Isofenphos]], [[Isoprocarb]], [[Latex allergy]], [[Malathion]], [[Mecarbam]], [[Methacrifos]], [[Methamidophos]], [[Methidathion]], [[Methiocarb]], [[Methomyl]], [[Methylene Diisocyanate]], [[Metiltriazotion]], [[Metolcarb]], [[Mevinphos]], [[Mexacarbate]], [[Monocrotophos]], [[Monosodium glutamate]], [[Nitrilacarb]], [[Nitrogen dioxide]], [[Nitromethane]], [[Omethoate]], [[Organophosphates]], [[Oxamyl]], [[Oxydeprofos]], [[Oxydisulfoton]], [[Parathion]], [[Parathion Methyl]], [[Phenkapton]], [[Phorate]], [[Phosalone]], [[Phosdrin]], [[Phosmet]], [[Phosphamidon]], [[Phoxim]], [[Pirimicarb]], [[Pirimiphos-methyl]], [[Platinosis|Platinum salts]], [[Primiphos methyl]], [[Profenofos]], [[Promacyl]], [[Promecarb]], [[Propoxur]], [[Prothidathion]], [[Prothoate]], [[Pyrimitate]], [[Quinalphos]], [[Quintiofos]], [[Radiocontrast]], [[Scombroid]], [[Smoke inhalation]], [[Sophamide]], [[Sulfotep]], [[Sulfur Trioxide]], [[Tazimcarb]], [[Terbufos]], [[Tetraethyl Pyrophosphate]], [[Tetrodotoxin]], [[Thiocarboxime]], [[Thiodicarb]], [[Thiofanox]], [[Thiometon]], [[Tolclofos methyl]], [[Toluene Diisocyanate]], [[Triazophos]], [[Triazotion]], [[Trifenfos]], [[Trimethacarb]], [[Vamidothion]], [[XMC]], [[Xylylcarb]], [[Analgesic asthma syndrome]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Dermatologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Drug Side Effect'''
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| |bgcolor="Beige"| [[Abciximab]], [[Acetylcysteine]], [[Acetylsalicylic acid]], [[Adenosine]], [[Alemtuzumab]], [[Aspirin]], [[Atenolol]], [[Atracurium]], [[Benzonatate]], [[Beta-blockers]], [[Betahistine]], [[Betaxolol]], [[Bethanechol]], [[Cocaine]], [[Colistin]], [[Cyclizine]], [[Diclofenac]], [[Felbinac]], [[Hydroxyethyl starch]], [[Ibritumomab tiuxetan]], [[Ibuprofen]], [[Indometacin]], [[Ketamine]], [[Ketorolac]], [[Labetalol]], [[Nadolol]], [[Nitrazepam]], [[NSAIDs]], [[Penicillin]], [[Pentamidine]], [[Pilocarpine]], [[Propafenone]], [[Propranolol]], [[Rapacuronium]], [[Streptokinase]], [[Timolol]], [[Zanamivir]], [[Decongestants]], [[Oxymetazoline]], [[Phenylephrine]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Ear Nose Throat'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Endocrine'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Environmental'''
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| |bgcolor="Beige"| [[Byssinosis]], [[Pollen allergy]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Gastroenterologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Genetic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Hematologic'''
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| |bgcolor="Beige"| [[Hypereosinophilic syndrome]], [[Mastocytosis]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Iatrogenic'''
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| |bgcolor="Beige"| [[Blood transfusion]], [[Bronchial challenge test]], [[Exercise stress testing]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Infectious Disease'''
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| |bgcolor="Beige"| [[Pfiesteria piscicida ]], [[Pneumonia]], [[Schistosomiasis]], [[Pulmonary eosinophilia]], [[Pulmonary strongyloidiasis]], [[Viral illness]], [[Visceral larva migrans]], [[Allergic bronchopulmonary aspergillosis]], [[Bronchiolitis]], [[LRTI]], [[URTI]], [[Giardiasis]]
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| |-bgcolor="LightSteelBlue"
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| | '''Musculoskeletal / Ortho'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Neurologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Nutritional / Metabolic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Obstetric/Gynecologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Oncologic'''
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| |bgcolor="Beige"| [[Carcinoid tumour ]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Opthalmologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Overdose / Toxicity'''
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| |bgcolor="Beige"| [[Abciximab]], [[Acetylcysteine]], [[Acetylsalicylic acid]], [[Adenosine]], [[Alemtuzumab]], [[Aspirin]], [[Atenolol]], [[Atracurium]], [[Benzonatate]], [[Beta-blockers]], [[Betahistine]], [[Betaxolol]], [[Bethanechol]], [[Cocaine]], [[Colistin]], [[Cyclizine]], [[Diclofenac]], [[Felbinac]], [[Hydroxyethyl starch]], [[Ibritumomab tiuxetan]], [[Ibuprofen]], [[Indometacin]], [[Ketamine]], [[Ketorolac]], [[Labetalol]], [[Nadolol]], [[Nitrazepam]], [[NSAIDs]], [[Penicillin]], [[Pentamidine]], [[Pilocarpine]], [[Propafenone]], [[Propranolol]], [[Rapacuronium]], [[Streptokinase]], [[Timolol]], [[Zanamivir]], [[Decongestants]], [[Oxymetazoline]], [[Phenylephrine]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Psychiatric'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Pulmonary'''
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| |bgcolor="Beige"| [[Shaver's disease]], [[Allergic bronchopulmonary aspergillosis]], [[Asthma]], [[Bronchiolitis]], [[Bronchopulmonary dysplasia]], [[Emphysema]], [[Churg-Strauss syndrome]], [[Analgesic asthma syndrome]], [[Pneumonia]], [[Pulmonary strongyloidiasis]], [[Aspiration]], [[Byssinosis]], [[COPD]], [[LRTI]], [[URTI]]
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| |-bgcolor="LightSteelBlue"
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| | '''Renal / Electrolyte'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Rheum / Immune / Allergy'''
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| |bgcolor="Beige"| [[Anaphylaxis]], [[Food allergy]], [[Peanut allergy]], [[Pollen allergy]], [[Latex allergy]], [[Anaphylactic shock]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Sexual'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Trauma'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Urologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Dental'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Miscellaneous'''
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| |bgcolor="Beige"| [[Anaphylaxis]], [[Anaphylactic shock]], [[Aspiration]], [[Exercise induced bronchospasm]], [[Food allergy]], [[Clove cigarette smoking]], [[Near-drowning]], [[Peanut allergies]], [[Carcinoid syndrome]], [[Snake bite]], [[Latex allergy]], [[Pollen allergy]], [[Cocaine]]
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| |-
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| |}
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| === Causes in Alphabetical Order === | | ==Diagnosis== |
| | [[Bronchospasm history and symptoms| History and Symptoms]] | [[Bronchospasm physical examination | Physical Examination]] | [[Bronchospasm laboratory findings|Laboratory Findings]] | [[Bronchospasm chest x ray|Chest X Ray]] | [[Bronchospasm CT|CT]] | [[Bronchospasm MRI|MRI]] | [[Bronchospasm ultrasound|Ultrasound]] | [[Bronchospasm other imaging findings|Other Imaging Findings]] | [[Bronchospasm other diagnostic studies|Other Diagnostic Studies]] |
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| {{MultiCol}}
| | ==Treatment== |
| *[[5-Hydroxyindoleacetic acid]]
| | [[Bronchospasm medical therapy|Medical Therapy]] | [[Bronchospasm surgery|Surgery]] | [[Bronchospasm primary prevention|Primary Prevention]] | [[Bronchospasm secondary prevention|Secondary Prevention]] | [[Bronchospasm cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Bronchospasm future or investigational therapies|Future or Investigational Therapies]] |
| *[[Abciximab]]
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| *[[Acetylcysteine]]
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| *[[Acetylsalicylic acid]]
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| *[[Adenosine]]
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| *[[Alanycarb]]
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| *[[Aldicarb]]
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| *[[Aldoxycarb]]
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| *[[Alemtuzumab]]
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| *[[Allergic bronchopulmonary aspergillosis]]
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| *[[Allyxycarb]]
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| *[[Amidithion]]
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| *[[Aminocarb]]
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| *[[Amiton]]
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| *[[Analgesic asthma syndrome]]
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| *[[Anaphylactic shock]]
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| *[[Anaphylatoxin]]
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| *[[Anaphylaxis]]
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| *[[Aspiration]]
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| *[[Aspirin]]
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| *[[Asthma]]
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| *[[Atenolol]]
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| *[[Athyl-Gusathion]]
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| *[[Atracurium]]
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| *[[Azinfosethyl]]
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| *[[Azinfos-methyl]]
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| *[[Azinophos-methyl]]
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| *[[Azinphos]]
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| *[[Azinphos-ethyl]]
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| *[[Azinphos-methyl]]
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| *[[Azinphosmetile]]
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| *[[Azothoate]]
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| *[[Bendiocarb]]
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| *[[Benfuracarb]]
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| *[[Benoxafos]]
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| *[[Benzonatate]]
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| *[[Beta-blockers]]
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| *[[Betahistine]]
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| *[[Betaxolol]]
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| *[[Bethanechol]]
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| *[[Blood transfusion]]
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| *[[Bromophos]]
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| *[[Bromophos-ethyl]]
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| *[[Bronchial challenge test]]
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| *[[Bronchiolitis]]
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| *[[Bronchopulmonary dysplasia]]
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| *[[Bufencarb]]
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| *[[Butacarb]]
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| *[[Butocarboxim]]
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| *[[Butoxcarboxim]]
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| *[[Byssinosis]]
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| *[[Cadusafos]]
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| *[[Carbamates]]
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| *[[Carbaryl]]
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| *[[Carbofuran]]
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| *[[Carbophenothion]]
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| *[[Carbosulfan]]
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| *[[Carcinoid syndrome]]
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| *[[Carcinoid tumour ]]
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| *[[Caterpillar poisoning]]
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| *[[Chlorfenvinphos]]
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| *[[Chlorine Dioxide]]
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| *[[Chloroacetophenone]]
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| *[[Chlorobenzylidene Malononitrile]]
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| *[[Chloropyrifos]]
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| *[[Chlorpyrifos methyl]]
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| *[[Churg-Strauss syndrome]]
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| *[[Cloethocarb]]
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| *[[Clove cigarette smoking]]
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| *[[Cocaine]]
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| *[[Colistin]]
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| *[[COPD]]
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| *[[CS gas]]
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| *[[Cyanthoate]]
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| *[[Cyclizine]]
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| *[[Decarbofuran]]
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| *[[Decongestants]]
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| {{ColBreak}}
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| *[[Demeton]]
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| *[[Demeton-methyl]]
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| *[[Demeton-O]]
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| *[[Demeton-O-methyl]]
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| *[[Demeton-S-methyl]]
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| *[[Demeton-S-methylsulphon]]
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| *[[Dialifos]]
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| *[[Diazinon]]
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| *[[Dichlorvos]]
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| *[[Diclofenac]]
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| *[[Dicresyl]]
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| *[[Dicrotophos]]
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| *[[Dimetan]]
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| *[[Dimethoate]]
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| *[[Dimetilan]]
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| *[[Dioxacarb]]
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| *[[Dioxathion]]
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| *[[Disulfoton]]
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| *[[EMPC]]
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| *[[Emphysema]]
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| *[[Endothion]]
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| *[[Ethiofencarb]]
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| *[[Ethion]]
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| *[[Ethoate-methyl]]
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| *[[Ethoprophos]]
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| *[[Ethyl-guthion]]
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| *[[Etrimfos]]
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| *[[Eucalyptus oil ]]
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| *[[Exercise induced bronchospasm]]
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| *[[Exercise stress testing]]
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| *[[Felbinac]]
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| *[[Fenchlorphos]]
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| *[[Fenethacarb]]
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| *[[Fenitrothion]]
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| *[[Fenobucarb]]
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| *[[Fensulfothion]]
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| *[[Fenthion]]
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| *[[Fonophos]]
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| *[[Food allergy]]
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| *[[Formothion]]
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| *[[Furathiocarb]]
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| *[[Giardiasis]]
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| *[[Gonionemus poisoning]]
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| *[[Guthion (ethyl)]]
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| *[[Heptenophos]]
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| *[[Hydrogen sulfide]]
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| *[[Hydroxyethyl starch]]
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| *[[Hypereosinophilic syndrome]]
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| *[[Hyquincarb]]
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| *[[Ibritumomab tiuxetan]]
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| *[[Ibuprofen]]
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| *[[Indometacin]]
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| *[[Iodofenphos]]
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| *[[Isofenphos]]
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| *[[Isoprocarb]]
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| *[[Ketamine]]
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| *[[Ketorolac]]
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| *[[Labetalol]]
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| *[[Latex allergy]]
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| *[[LRTI]]
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| *[[Malathion]]
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| *[[Mastocytosis]]
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| *[[Mecarbam]]
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| *[[Methacrifos]]
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| *[[Methamidophos]]
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| *[[Methidathion]]
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| *[[Methiocarb]]
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| *[[Methomyl]]
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| *[[Methylene Diisocyanate]]
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| *[[Metiltriazotion]]
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| *[[Metolcarb]]
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| *[[Mevinphos]]
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| *[[Mexacarbate]]
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| *[[Monocrotophos]]
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| *[[Monosodium glutamate]]
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| *[[Nadolol]]
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| *[[Near-drowning]]
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| *[[Nitrazepam]]
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| {{ColBreak}}
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| *[[Nitrilacarb]]
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| *[[Nitrogen dioxide]]
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| *[[Nitromethane]]
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| *[[NSAIDs]]
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| *[[Omethoate]]
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| *[[Organophosphates]]
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| *[[Oxamyl]]
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| *[[Oxydeprofos]]
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| *[[Oxydisulfoton]]
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| *[[Oxymetazoline]]
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| *[[Parathion]]
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| *[[Parathion Methyl]]
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| *[[Peanut allergies]]
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| *[[Penicillin]]
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| *[[Pentamidine]]
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| *[[Pfiesteria piscicida ]]
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| *[[Phenkapton]]
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| *[[Phenylephrine]]
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| *[[Phorate]]
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| *[[Phosalone]]
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| *[[Phosdrin]]
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| *[[Phosmet]]
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| *[[Phosphamidon]]
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| *[[Phoxim]]
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| *[[Pilocarpine]]
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| *[[Pirimicarb]]
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| *[[Pirimiphos-methyl]]
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| *[[Platinosis|Platinum salts]]
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| *[[Pneumonia]]
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| *[[Pollen allergy]]
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| *[[Primiphos methyl]]
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| *[[Profenofos]]
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| *[[Promacyl]]
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| *[[Promecarb]]
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| *[[Propafenone]]
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| *[[Propoxur]]
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| *[[Propranolol]]
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| *[[Prothidathion]]
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| *[[Prothoate]]
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| *[[Pulmonary eosinophilia]]
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| *[[Pulmonary strongyloidiasis]]
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| *[[Pyrimitate]]
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| *[[Quinalphos]]
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| *[[Quintiofos]]
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| *[[Radiocontrast]]
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| *[[Rapacuronium]]
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| *[[Schistosomiasis]]
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| *[[Scombroid]]
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| *[[Shaver's disease]]
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| *[[Smoke inhalation]]
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| *[[Snake bite]]
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| *[[Sophamide]]
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| *[[Streptokinase]]
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| *[[Sulfotep]]
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| *[[Sulfur Trioxide]]
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| *[[Tazimcarb]]
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| *[[Terbufos]]
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| *[[Tetraethyl Pyrophosphate]]
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| *[[Tetrodotoxin]]
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| *[[Thiocarboxime]]
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| *[[Thiodicarb]]
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| *[[Thiofanox]]
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| *[[Thiometon]]
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| *[[Timolol]]
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| *[[Tolclofos methyl]]
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| *[[Toluene Diisocyanate]]
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| *[[Triazophos]]
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| *[[Triazotion]]
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| *[[Trifenfos]]
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| *[[Trimethacarb]]
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| *[[URTI]]
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| *[[Vamidothion]]
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| *[[Viral illness]]
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| *[[Visceral larva migrans]]
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| *[[XMC]]
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| *[[Xylylcarb]]
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| *[[Zanamivir]]
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| {{EndMultiCol}}
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|
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| == Treatment == | | ==Case Studies== |
| | | [[Bronchospasm case study one|Case#1]] |
| === Pharmacotherapy ===
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| ==== Beta 2 agonists ====
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| | |
| Beta 2 [[adrenergic agonist]]s are recommended for bronchospasm.
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| *Short acting (SABA)
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| **[[Salbutamol]]
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| **[[Levosalbutamol]]
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| *Long acting (LABA)
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| **[[Formoterol]]
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| **[[Salmeterol]]
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| *Others
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| **[[Dopamine]]
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| **[[Norepinephrine]]
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| **[[Epinephrine]]
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| ==== Muscarinic Acetylcholine receptor antagonist ====
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| Since the neurotransmitter, [[acetylcholine]], is known to decrease sympathetic response by slowing the heart rate and constricting the [[smooth muscle tissue]]; ongoing research and successful clinical trials have shown that agents such as [[diphenhydramine]], [[atropine]] and [[Ipratropium bromide]] is known to be effective for treating asthma and COPD-related symptoms.
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| == References == | | == References == |