title: [The brittle asthmatic and the morning dipper].
abstract: The terms 'brittle asthmatic' and 'morning dipper' were first used by Turner-Warwick in 1977. Since then, the issue of brittle asthmatic is that all attempts to stabilize lower readings in peak expiratory flow (PEF) with regular beta 2-agonists, such as slow compound, oral preparations, or combinations with theophylline seem to fail, although they are rapidly reversed by inhaled beta 2-agonists. In brittle asthmatics regularly treated with a long-acting beta 2-agonist and a sustained-release theophylline, an oral cysteinyl leukotriene antagonist, pranlukast, almost completely inhibited a chaotic pattern of PEF readings. Thus, I suggested that the lower readings might depend on a transient release of cysteinyl leukotriene. In addition, I showed that a long-acting beta 2-agonist, tulobuterol tape, significantly improved a morning dip in PEF readings.
authors.affiliation: 1st Department of Internal Medicine, Tohoku University School of Medicine.
authors.forename: G
authors.initials: G
authors.lastname: Tamura
mesh_terms: D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000503:physiopathology*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002867:Chromones / Q000627:therapeutic use; D002940:Circadian Rhythm; D003907:Dexamethasone / Q000627:therapeutic use; D006801:Humans; D020024:Leukotriene Antagonists; D008565:Membrane Proteins; D010366:Peak Expiratory Flow Rate; D018077:Receptors, Leukotriene; D013726:Terbutaline / Q000031:analogs & derivatives / Q000627:therapeutic use; D013806:Theophylline / Q000627:therapeutic use
chemical_list: D000318:Adrenergic beta-Agonists; D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D002867:Chromones; D020024:Leukotriene Antagonists; D008565:Membrane Proteins; D018077:Receptors, Leukotriene; C010809:tulobuterol; D003907:Dexamethasone; C412375:cysteinyl leukotriene receptor 2; D013806:Theophylline; C083169:leukotriene D4 receptor; D013726:Terbutaline; C047681:pranlukast