title: [Exacerbations of asthma--precipitating factors: drugs].
abstract: Asthmatic exacerbations are sometimes triggered by medications, primarily the non-steroidal anti-inflammatory agents (NSAIDS) and beta-blockers. Asthma attacks induced by NSAIDS occur rapidly and can be severe. Widal syndrome is a specific disease entity whose physiopathology remains incompletely explained. Asthma is characteristically severe and steroid dependent; desensitisation with aspirin has been proposed, but this remains controversial. Beta-blockers are contra-indicated in asthma; the β1 "cardioselectivity" of some agents is not absolute, disappearing at high doses and the "partial agonists" are not better tolerated. However, certain authors have called into question the harmful effect of beta-blockade in moderate and stable asthma. More studies are needed, but the current data suggest that in some cases beta-blockers may be safe but their use requires close supervision. Other molecules can pose problems in asthmatics (dipyridamole, synthetic sex hormones and certain excipients). On the whole, there has been little innovation concerning the hazard that drugs can pose for some asthmatics. The task for the future will be to specify the physiopathology of Widal syndrome, and to clarify the categories of patients in whom beta-blockers can be safely employed as the public health consequences of cardiovascular pathologies make this an important issue for lung specialists.
authors.affiliation: Inserm EA4319, Service de Pneumologie, Faculté de Médecine, Université de Nice Sophia Antipolis, hôpital Pasteur, CHU de Nice, 30, avenue de la Voie-Romaine, BP 1069, 06002 Nice cedex 1, France.
authors.forename: C
authors.initials: C
authors.lastname: Sanfiorenzo
authors.forename: A
authors.initials: A
authors.lastname: Pipet
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D001249:Asthma / Q000139:chemically induced / Q000209:etiology* / Q000473:pathology; D000075202:Contraindications; D004176:Dipyridamole / Q000009:adverse effects; D018450:Disease Progression; D064420:Drug-Related Side Effects and Adverse Reactions; D005079:Excipients / Q000009:adverse effects; D042341:Gonadal Hormones / Q000009:adverse effects; D006801:Humans; D008954:Models, Biological; D016273:Occupational Exposure / Q000009:adverse effects; D004364:Pharmaceutical Preparations; D015985:Precipitating Factors
chemical_list: D000319:Adrenergic beta-Antagonists; D000894:Anti-Inflammatory Agents, Non-Steroidal; D005079:Excipients; D042341:Gonadal Hormones; D004364:Pharmaceutical Preparations; D004176:Dipyridamole