What is the first-line medication for pediatric bronchospasm?

• A. Epinephrine via injection
• B. Ipratropium bromide inhalation
• C. Theophylline oral
• D. Albuterol via inhalation

Answer: (D)

Albuterol delivered by inhalation is the fastest, most effective relief for acute bronchospasm in children. It’s a short-acting beta-2 agonist that directly relaxes airway smooth muscle, rapidly opening the airways and improving breathing. Because it works in the lungs, it provides quick relief with fewer systemic effects, which is why it’s the first-line choice. In kids, using a spacer with a metered-dose inhaler or a small-volume nebulizer helps ensure the medication reaches the lungs.

Epinephrine injections are reserved for life-threatening or anaphylactic situations, not routine pediatric bronchospasm. Ipratropium bromide inhalation can be added for more severe or unresponsive cases but isn’t the initial stand-alone choice. Theophylline, given orally, is outdated for acute management due to a narrow therapeutic window and potential side effects, so it isn’t used first-line.