طفل عمره ٨ سنوات في نوبة ربو شديدة لم تتحسن بعد السالبيوتامول والإبراتروبيوم المتكرر والكورتيزون، وتشبعه ٩٠٪. أي دواء وريدي قد يُضاف؟

An 8-year-old in a severe asthma attack has not improved after repeated salbutamol and ipratropium and steroids, with SpO2 90%. Which IV drug may be added?

1. Morphine to calm the breathing
2. Furosemide to dry the lungs
3. Magnesium sulphate
4. Propranolol to slow the fast heart rate

Answer: C) Magnesium sulphate. In severe refractory asthma, IV magnesium relaxes bronchial smooth muscle. Non-selective beta-blockers cause bronchospasm, and sedatives depress breathing.