title: Relief of dyspnoea by beta2-agonists after methacholine-induced bronchoconstriction.
abstract: Virtually all asthma patients use brorichodilators. Formoterol and salbutamol have a rapid onset of bronchodilating effect, whereas salmeterol acts slower. We studied the onset of improvement of dyspnoea sensation after inhalation with these bronchodilators and placebo to reverse a methacholine-induced bronchoconstriction as a model for an acute asthma attack. Seventeen patients with asthma completed this randomised, double-blind, crossover, double-dummy study. On 4 test days, forced expiratory volume in 1 s (FEV1) and Borg score were recorded and patients were challenged with methacholine until FEV1 fell with > or = 30% of baseline value. Thereafter, formoterol 12 microg via Turbuhaler, salbutamol 50 microg via Turbuhaler, salmeterol 50 microg via Diskhaler, or placebo was inhaled. FEV1 and Borg scores were assessed during the following 60 min. The first sensed improvement of Borg score was significantly (P<0.05) faster achieved with formoterol (geometric mean (Gmean) (range) 1.5 (1-40) min) and salbutamol 1.8 (1-10) min than with salmeterol 4.5 (1-30) min and placebo 3.4 (1-40) min. The Borg score returned significantly faster to the baseline value with formoterol, salbutamol, and salmeterol (Gmean time 13.8 (1-75), 13.4 (1-60), and 18.0 (1-75) min, respectively) than with placebo (33.6 (1-75 min). Formoterol and salbutamol act significantly faster than salmeterol in relieving dyspnoea induced by methacholine-induced bronchoconstriction, in patients with asthma.
authors.affiliation: Department of Pulmonary Diseases, Martini Hospital, PO Box 30033, RM Groningen 9728, The Netherlands. h.woude@mzh.nl
authors.forename: Hanneke J
authors.initials: HJ
authors.lastname: van der Woude
authors.forename: Dirkje S
authors.initials: DS
authors.lastname: Postma
authors.forename: Mathijs J
authors.initials: MJ
authors.lastname: Politiek
authors.forename: Trea H
authors.initials: TH
authors.lastname: Winter
authors.forename: René
authors.initials: R
authors.lastname: Aalbers
mesh_terms: D000293:Adolescent; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage*; D000328:Adult; D000420:Albuterol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D001249:Asthma / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D016084:Bronchoconstriction / Q000187:drug effects; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004417:Dyspnea / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D004983:Ethanolamines / Q000008:administration & dosage; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D000068759:Formoterol Fumarate; D006801:Humans; D008297:Male; D016210:Methacholine Chloride; D009330:Nebulizers and Vaporizers; D000068299:Salmeterol Xinafoate; D013997:Time Factors
chemical_list: D000318:Adrenergic beta-Agonists; D001993:Bronchodilator Agents; D004983:Ethanolamines; D016210:Methacholine Chloride; D000068299:Salmeterol Xinafoate; D000420:Albuterol; D000068759:Formoterol Fumarate