Three generations of ongoing controversies concerning the use of short acting beta-agonist therapy in asthma: a review.
An increase in asthma mortality in 1960s noted by British authors stirred a debate about the use of beta-adrenergic therapy that has persisted in the medical literature. The cause appears to be isoproterenol and fenoterol overuse. A second debate evolved around the possible deleterious, pro-inflammatory effects, of the albuterol distomer. Most clinical studies showed improved bronchodilatation, but limited benefits from using levalbuterol. Recently, genotyping has uncovered a single nucleotide polymorphism at codon 16 that appears to affect the long term response to both regular and as needed use of albuterol, calling for a new genotype based therapeutic approach in asthma.
Jalba
Mihai-Sergiu
MS
Health Services Research Postdoctoral Fellowship Program, Division of Research, Department of Family Medicine, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, Piscataway, New Jersey, USA. drmjalba@netzero.net
D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000009:adverse effects*; D000420:Albuterol / Q000008:administration & dosage / Q000009:adverse effects; D001249:Asthma / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D006801:Humans; D011110:Polymorphism, Genetic; D011943:Receptors, Adrenergic, beta / Q000235:genetics; D013997:Time Factors
D000318:Adrenergic beta-Agonists; D011943:Receptors, Adrenergic, beta; D000420:Albuterol