Day-night variation of airways status in sympathomimetic- and theophylline-treated asthma patients.
Eleven diurnally active asthma patients having a history of nocturnal asthma and treated regularly with albuterol or metaproterenol alone or with twice-daily sustained-release theophylline were evaluated for day-night pattern in peak expiratory flow (PEF) and use of supplemental beta-agonist aerosol for relief of acute asthma. Overall, significant day-night variation was observed in the supplemental use of beta-agonist medication and in airway patency. The patients managed by albuterol or metaproterenol alone used supplemental beta-agonist medication significantly more between 4 AM and 8 AM and also 8 PM and midnight in comparison to 4 PM to 8 PM; this was not true for those treated with both theophylline and beta-agonist aerosol. In patients taking a beta-agonist bronchodilator, the 24-hour mean PEF was greater than in those who also took theophylline, but the day-night variation in PEF was comparable. Supplemental isoproterenol use was significantly correlated with circadian amplitude of the PEF rhythm, but not with the 24-hour mean PEF. The greater the day-night variation in PEF, the greater the reliance on a supplemental beta-agonist bronchodilator.
Brown
A C
AC
School of Public Health, University of Texas Health Science Center, Houston.
Smolensky
M H
MH
D'Alonzo
G E
GE
D000280:Administration, Inhalation; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001249:Asthma / Q000188:drug therapy / Q000503:physiopathology*; D002940:Circadian Rhythm; D003692:Delayed-Action Preparations; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007545:Isoproterenol / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010366:Peak Expiratory Flow Rate / Q000502:physiology*; D013806:Theophylline / Q000627:therapeutic use*
D003692:Delayed-Action Preparations; D013806:Theophylline; D007545:Isoproterenol