Which drug is commonly used to relieve acute bronchospasm in suspected asthma on board, with guidance?

• A. Diphenhydramine
• B. Albuterol via MDI with spacer (or nebulized)
• C. Epinephrine
• D. Acetaminophen

Answer: (B)

Acute bronchospasm from suspected asthma is treated most effectively with a rapid-acting inhaled bronchodilator. Albuterol works quickly by stimulating beta-2 receptors in the airway smooth muscle, causing immediate relaxation and opening of the airways within minutes. Using a metered-dose inhaler with a spacer helps deliver more medicine to the lungs, making it the preferred method; if a spacer isn’t available, a nebulized form is equally effective. This approach directly addresses the airway constriction that defines bronchospasm, giving prompt relief of wheeze and shortness of breath.

Antihistamines like diphenhydramine don’t relieve bronchospasm and won’t reverse airway smooth muscle constriction. Acetaminophen has no bronchodilating effect. Epinephrine is reserved for more severe, life-threatening situations (such as anaphylaxis or extreme airway compromise) and not as the first-line treatment for routine on-board asthma symptoms.