Protective effects of different doses of inhaled fenoterol on methacholine-induced bronchoconstriction in asthmatic children

Authors

  • Irma Douglas Gomez Universidade Federal de São Paulo
  • Marilia de Dirceu Silva Universidade Federal de São Paulo
  • Maria Poliana Bueno Universidade Federal de São Paulo
  • Dirceu Solé Universidade Federal de São Paulo
  • Charles Kirov Naspitz Universidade Federal de São Paulo

Keywords:

Asthma, Children, Bronchial hyperreactivity, Beta agonists, Fenoterol, Methacholine

Abstract

OBJECTIVE: To evaluate the protective effect of different doses of inhaled fenoterol (F) on bronchoconstriction induced by methacholine (M). DESIGN: randomized double-blind study. SETTING: Referrence center. PARTICIPANTS: 9 children (aged from 7 to 15 years old), with mild or moderate asthma and allergic to D. pteronyssinus. INTERVENTION: On the first day, the M concentration necessary to induce a 20% fall in the forced expiratory volume in the first second (FEV1; PC20FEV1) was determined using closed circuit inhalation (De Vilbiss 646). On subsequent days, the children inhaled a dose of F (25 or 50 or 100 or 200 µg) through the same circuit and, after 15 minutes the FEV1 was measured, becoming the basal value. Bronchoprovocation was then initiated using the concentration prior to the PC20FEV1 of the first day and continuing until there was a 20% fall in the FEV1. This concentration was the "new" PC20FEV1. RESULTS: F in a dose of 25 µg protected 2 of the 9 children, in a dose of 50 mg protected 4 of the 9 and in doses of 100 and 200 µg protected all children. We did not observe any relationship between the magnitude of the bronchodilation and bronchoprotection induced by the inhalation of F. CONCLUSIONS: Our results suggest that a dose of 100 µg of F is capable of inducing bronchoprotection in children with mild/moderate asthma.

Downloads

Download data is not yet available.

Author Biographies

Irma Douglas Gomez, Universidade Federal de São Paulo

Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil

Marilia de Dirceu Silva, Universidade Federal de São Paulo

Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil

Maria Poliana Bueno, Universidade Federal de São Paulo

Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil

Dirceu Solé, Universidade Federal de São Paulo

Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil

Charles Kirov Naspitz, Universidade Federal de São Paulo

Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil

References

Sociedade Brasileira de Alergia e Imunopatologia, Sociedade Brasileira de Pediatria, Sociedade Brasileira de Pneumologia e Tisiologia. 1o Consenso Brasileiro no Manejo da Asma, São Paulo: Bg Cultural;1994:42.

Global Strategy for asthma management and prevention. NHLBI/WHO Workshop. National Heart, Lung and Blood Institute publication 1995;95:3659.

Spector SL, Nicklas RA. Practice parameters for the diagnosis and treatment of asthma. J Allergy Clin Immunol 1995;96:707-870.

Canadian Thoracic Society, Canadian Paediatric Society, Canadian Society of Allergy and Immunology, Canadian Association of Emergency Physicians, College of Family Physicians of Canada, and Family Physician Asthma Group of Canada. Report on the working groups for the Canadian Asthma Consensus Conference. Can Respir J 1996;3:1B- 44B.

National Institutes of Health and National Heart, Lung and Blood Institute. Practical Guide for the Diagnosis and Management of Asthma, NIH publication 1997;97:4053.

Naspitz CK, Solé D, Salto-Jr JJ. Beta 2 agonists and death from asthma. J Allergy Clin Immunol 1994;93:677.

Mullen M, Mullen B, Carey M. The association between b-agonist use and death from asthma. A meta-analytic integration of case-control studies. JAMA 1993;270:1842- 5.

Bandouvakis J, Cartier A, Roberts R. The effect of ipratropium bromide and fenoterol on methacholine- and histamine-induced bronchoconstriction. Br J Dis Chest 1981;75:295-305.

Salome CM, Schoeffel RE, Woolcock AJ. Effect of aerosol and oral fenoterol on histamine and methacholine challenge in asthmatic subjects. Thorax 1981;36:580-4.

Salome CM, Schoeffel RE, Yan K, Woolcock AJ. Effect of aerosol fenoterol on the severity of bronchial hyperreactivity in patients with asthma. Thorax 1983;38:854-8.

Salome CM, Wright W, Sedgwick CJ, Woolcock AJ. Acute effects of fenoterol (Berotec) and ipratropium bromide (Atrovent) alone and in combination on bronchial hyperresponsiveness in asthmatic subjects In: Black J, Armour C, editors. Mechanisms in Asthma Pharmacology, Physiology, and Management. New York: Alan R Liss 1988;405-19.

Magnussen H, Rabe KF. Low dose fenoterol aerosol protects against histamine-induced bronchoconstriction in mild asthmatics: a dose response study. Clin Exper Allergy 1992;22:690-3.

Rabe KF, Jörres R, Magnussen H. The effect of 10, 50 and 200 mg inhaled fenoterol on exercise induced asthma. Clin Exper Allergy 1993;23:440-5.

American Thoracic Society. Lung function testing selection of reference values and interpretative strategies. Am Rev Respir Dis 1991;144:1202-18.

Mallozi MC, Solé D, Naspitz CK . Broncoprovocaçăo com histamina e metacolina em crianças com asma brônquica e crianças normais. J Pneumol 1991;17:69-73.

Chai H, Fan RS, Froehlich LA. Standardization of bronchial inhalation challenge procedures. J Allergy Clin Immunol 1975;56:323-7.

Polgar G, Promadaht V. Pulmonary function testing in children. Philadelphia: WB Saunders 1971;273.

Spitzer WO, Suissa S, Ernst P, et al. The use of b-agonists and the risk of death and near death from asthma. N Engl J Med 1992;326:501-6.

Sears MR, Taylor DR, Print CG. Regular inhaled b-agonist treatment in bronchial asthma. Lancet 1990;336:1391-6.

Piacentini GL, Peroni DG, Vicentini L, et al. Beta 2 agonists, exposure to allergens and bronchial hyperreactivity in childen with allergic asthma. Pediatr Med Chir 1995;17:515-7.

Drazen JF, Israel E, Boushey HA, et al. Comparison of regularly scheduled with as needed use of albuterol in mild asthma. N Engl J Med 1996;335:841-7.

Apter AJ, Reisine ST, Willard A, et al. The effect of inhaled albuterol in moderate to severe asthma. J Allergy Clin Immunol 1996;98:295-301.

Downloads

Published

1998-11-11

How to Cite

1.
Gomez ID, Silva M de D, Bueno MP, Solé D, Naspitz CK. Protective effects of different doses of inhaled fenoterol on methacholine-induced bronchoconstriction in asthmatic children. Sao Paulo Med J [Internet]. 1998 Nov. 11 [cited 2025 Oct. 16];116(6):1834-7. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/2383

Issue

Section

Original Article