Quick advice needed - Xopenex and fast heart rate

[lmk1]

DS (27months) is wheezing and Dr. has ordered xopenex 4 or 5 times per day for a couple of days and then 3 times per day to round out a week. Ds' heartbeat is VERY fast and the Dr. heard that too and said that's a side effect of the xopenex. Given that overdosing on xopenex can result in cardiac arrest, I am very scared to do the 4-6 hour interval that the Dr wanted. Ds also has a fever now that we gave him Tylenol for...and I'm afraid that might be adding to the fast heart rate.

Does anyone have any experience with xopenex and these side effects? I'd like to put him to bed now and want to do a treatment before then. He's been up since 6am!!! His last treatment was around 4:30pm.
xposted in Health & HEaling.

[DiannaK]

I'm an ER nurse (been a nurse for 16 years), and in my experience, Xopinex does not cause as much of a problem with increasing heart rate as does Albuterol.

I'd give him Tylenol (or Motrin), a treatment for sure before going to bed. I think a 4 to 6 hour window is fine ... you can stretch it to 6 to 8 hours if you're worried, but it sounds like he needs these treatments, at least here in the short term.

Good luck .... we're dealing with pneumonia and wheezing here -- one of my boys is on abx, steroids and treatments.

[lmk1]

thanks. We did the Tylenol, but it didn't seem to bring the fever down, and it came down to normal about 3 hours later....so I'm hoping the fever part of this virus is over. We did a treatment, but how do I know it's working? He was coughing quite a bit still. We're now doing another treatment (dh is, I'm pg so trying to stay out of the xonepex). His resp rate is 30. He also seems to be getting really hoarse. Do kids this age lose their voice?

Good luck with your boy. I hope he gets well quickly. It seems that kids this age get really sick often...it really makes me wonder how anyone ever survived before the nebulizer???

[kat726]

I'm also an ER nurse and I would ask...what's really fast?

Fast to one person is not fast to another and children's heart rates tend to be higher than adults. Fever will also cause a spike in pulse rate.

So that's my question.

What's the pulse getting up to? And how long is it staying there?

Hope he's feeling better now.

Katherine

[lmk1]

Thanks, I think we're past the fast heart rate. I can't tell you how fast, but even the nurse at the Dr's office noted it was fast. Dr wanted him on xopenex for 48 hours, every 4-5 hours, and then after every 6-8 hours to round out the week. We're done with 3 days approximately, and I'm wondering how much of an improvement should I hear/see in him? I can hear the congestion now...and I'm wondering how do I know if it becomes pneumonia? Last night he actually slept without coughing more than once or twice. But he is still coughing a lot. And I hear like a "snoring" or "crinkly paper" type sound from him (not all the time) that I heard last time he did have pneumonia. Last time, the xopenex helped with the pneumonia because it allowed the fluid to come out of his lungs, now I'm not sure if it's helping with breathing or not. Is 3 days too quick to hope for improvement in the cough? He plays and is active, and doesn't seem to be in distress.

Is it a good or bad idea to do a steaming hot shower now to try and get some mucus out of him?

[kat726]

I'm glad to know that he's feeling better.

Right off, let me just say that this is just advice based on what you are telling me. Without seeing him and listening to him, there's no way to know anything for sure. If you are ever concerned about his ability to breath you should go to your doctor or the ER for eval.

That being said...anytime your kid has a stuffy nose or congestion, warm humid air is good for them. It helps to loosen that mucus and make it not so thick. Keep him hydrated (lots of water and juice)...also good for the mucus.

You can't hear pnuemonia without a stethescope. The biggest thing is - does he seem to be feeling better? If so then he is on the mend. Even if he's still coughing, in general are his symptoms decreasing? Also keep in mind that duration-wise, he may not be still experiencing the same cold...he could have picked up a new virus. My 10 month-old has had a cough/cold for a month. It seems to get better, then he starts the coughing again. But I know that he keeps coming into contact with new viruses.

It sounds like you are doing what you need to. Use that great mother's intuition and call doc with any other questions.

Good luck
Katherine

[lmk1]

Thanks Kat,
I guess I'm just a little concerned because my intuition and general observation failed last time (when he ended up with pneumonia and then started wheezing for the first time). I'm one of those moms that has their kid at the Dr's office 4 times during a cold Last time, I was so not concerned because it seemed like he just got a minor cold that dragged on (and he probably got more viruses also, like you mentioned) and I'd already had him twice at the Dr's office, and his lungs sounded great both times.

So his runny nose is much better, he's coughing less at night, he's got no fever...however, he seems to not have much of an appetite now. So some things are better, but some not. I'll try taking him into a hot shower and just observe. I really feel like I should take a class in proper stethoscope usage (we actually bought one last time), so I can differentiate the digestive sounds from the lungs! Not to self treat, but at least help confirm that yes, he needs to be seen by a Dr.