[Bronchodilators in asthma: bypassing controversies].
Inhaled bronchodilators are used in acute asthma for relief of airway obstruction. Continuous monotherapy with beta 2 adrenergic can increase hyperresponsiveness because these drugs do not control inflammation. Asthma mortality and morbidity have been related to an increased beta 2-agonists use. Epidemiologic data however do not show a cause/effect relationship. Until controversies are cleared on, beta 2-agonists should be used for relieving acute asthma attacks, for preventing exercise-induced bronchospasm and eventually on an as needed basis. Long acting beta 2-agonists can be effective in moderate/severe asthma. Daily short acting beta 2 use by inhalation, a partial clinical response and its overuse in acute asthma suggest the need for antiinflammatory treatment.
Rosário Filho
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Departmento de Pediatria, UFPR, Curitiba, PR.