title: Drugs potentially affecting the extent of airways reversibility on pulmonary function testing are frequently consumed despite guidelines.
abstract: BACKGROUND
  The increase in forced expiratory volume in one second (FEV1) effected by a bronchodilator is routinely assessed when patients undertake pulmonary function testing (PFT). Several drug classes can theoretically affect the magnitude of the increase in FEV1. Withholding periods are advised for many but not all such drugs. Anecdotally, many subjects presenting for PFT are found to have taken drugs that might affect the test. We did an audit of patients presenting for PFT to assess the frequency with which FEV1 reversibility might be affected by drugs.
  
  
  METHODS
  One hundred subjects presenting to the laboratory for PFT were questioned about recent drug consumption by an independent pharmacy intern. Reversibility of FEV1 was assumed to have been affected if drugs of interest were consumed within defined withholding periods or two half-lives for drugs without such data.
  
  
  RESULTS
  Sixty-three subjects were prescribed drugs likely to affect FEV1 reversibility. Thirty-six subjects consumed at least one such drug within the withholding period. Half (18) of these patients consumed β-blockers with or without β-agonists. Sixty-five subjects did not recall receiving any advice about withholding drugs prior to the test and only 10 recalled receiving advice from their clinician or pulmonary function technician.
  
  
  CONCLUSIONS
  Subjects presenting for PFT are infrequently advised to withhold drugs that may affect FEV1 reversibility, and consequently, often take such drugs close to the time of the test. Therefore, it is likely that the increase in FEV1 is frequently affected by interference from drugs and this might impact on diagnosis and/or treatment options.
authors: Pharmacy Department, The Queen Elizabeth Hospital, Woodville South, SA, Australia. terry.jones@health.sa.gov.au
authors: Terry E
authors: TE
authors: Jones
authors: AnneMarie
authors: A
authors: Southcott
authors: Sean
authors: S
authors: Homan
mesh_terms: D018663:Adrenergic Agents / Q000494:pharmacology*; D000368:Aged; D001315:Australia; D001993:Bronchodilator Agents / Q000494:pharmacology*; D003951:Diagnostic Errors / Q000517:prevention & control*; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects*; D006207:Half-Life; D006801:Humans; D008297:Male; D010347:Patient Care Planning / Q000592:standards; D010818:Practice Patterns, Physicians' / Q000592:standards; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D012129:Respiratory Function Tests / Q000379:methods*; D013997:Time Factors; D028761:Withholding Treatment
chemical_list: D018663:Adrenergic Agents; D001993:Bronchodilator Agents
keywords: beta-adrenergic agonists; beta-adrenergic antagonists; bronchodilators; lung function tests; withholding periods
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