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Effect of different inhaled bronchodilators on recovery from methacholine-induced bronchoconstriction in asthmatic

A Quezada1, J Mallol, J Moreno

  • 1Department of Pediatrics, School of Medicine, University of Chile, Santiago, Chile.

Pediatric Pulmonology
|July 28, 1999
PubMed

Insights

Five inhaled asthma medications showed bronchodilator effects in children. Fenoterol and fenoterol with ipratropium bromide demonstrated significantly greater effects compared to other beta-agonist aerosols and placebo.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Pharmacology
  • Clinical Asthma Management

Background:

  • Mild to moderate asthma affects many children, necessitating effective bronchodilator therapies.
  • Metered dose inhaler (MDI) formulations are common delivery methods for asthma medications.
  • Understanding the comparative efficacy of different bronchodilators is crucial for optimal asthma control.

Purpose of the Study:

  • To evaluate the acute bronchodilator effects of five different metered dose inhaler (MDI) aerosol formulations in children with asthma.
  • To compare the efficacy of salbutamol, fenoterol, salbutamol with beclomethasone, fenoterol with ipratropium bromide, and salmeterol against a placebo.
  • To assess the bronchodilator response 5 minutes after inhalation.

Main Methods:

  • Two hundred fourteen children with mild to moderate asthma underwent methacholine bronchial challenge testing.
  • Participants were randomly assigned to receive one of six treatments: salbutamol, fenoterol, salbutamol + beclomethasone, fenoterol + ipratropium bromide, salmeterol, or placebo.
  • Bronchodilator effect was measured by forced expired volume in 1 second (FEV1) 5 minutes post-inhalation.

Main Results:

  • All five inhaled beta-agonist aerosols demonstrated a significant bronchodilator effect compared to placebo.
  • Fenoterol (F) and fenoterol + ipratropium bromide (F + IB) groups showed significantly greater bronchodilator effects (P < 0.05) than other formulations.
  • The study confirmed the ability of the tested aerosols to reverse methacholine-induced bronchoconstriction.

Conclusions:

  • Five different MDI aerosol formulations effectively reversed methacholine-induced bronchoconstriction in children with asthma within 5 minutes.
  • Fenoterol and fenoterol combined with ipratropium bromide exhibited superior bronchodilator efficacy among the tested beta-agonists.
  • These findings support the use of these bronchodilators for rapid relief of bronchoconstriction in pediatric asthma.

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