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Related Experiment Videos

Tolerance to beta-agonists during acute bronchoconstriction.

R J Hancox1, R E Aldridge, J O Cowan

  • 1Dept of Medicine, Dunedin School of Medicine, New Zealand.

The European Respiratory Journal
|October 9, 1999
PubMed
Summary
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Continuous use of inhaled beta-agonists may cause tolerance, reducing their effectiveness during asthma exacerbations. This study demonstrates reduced bronchodilator response during acute bronchoconstriction after 6 weeks of terbutaline treatment.

Area of Science:

  • Pulmonary Medicine
  • Pharmacology
  • Respiratory Research

Background:

  • Previous research indicated no tolerance to beta-agonist bronchodilators in stable asthma.
  • The potential for tolerance during acute bronchoconstriction remained unclear.

Purpose of the Study:

  • To investigate if bronchodilator tolerance to inhaled beta-agonists can be demonstrated during acute bronchoconstriction.
  • To assess the impact of continuous terbutaline and budesonide treatment on beta-agonist response.

Main Methods:

  • A randomized, double-blind, cross-over study involving 34 asthmatic subjects.
  • Six weeks of treatment with inhaled terbutaline, budesonide, both, or placebo.
  • Methacholine challenge to induce bronchoconstriction, followed by assessment of salbutamol response.

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Main Results:

  • A significant reduction (36%) in salbutamol response was observed after 6 weeks of terbutaline treatment compared to placebo (p<0.0001).
  • Concomitant budesonide treatment did not alter the reduced bronchodilator response.
  • Tolerance to inhaled beta-agonists was demonstrated during acute bronchoconstriction.

Conclusions:

  • Continuous treatment with inhaled beta-agonists can lead to tolerance.
  • This tolerance may reduce the effectiveness of emergency beta-agonist treatments during asthma exacerbations.