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Related Experiment Videos

Beta2-agonist tolerance and exercise-induced bronchospasm.

Robert J Hancox1, Padmaja Subbarao, Dennis Kamada

  • 1Asthma Research Group, Firestone Institute for Respiratory Health, McMaster University/St Joseph's Hospital, Hamilton, Ontario, Canada.

American Journal of Respiratory and Critical Care Medicine
|April 17, 2002
PubMed
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Regular use of inhaled beta-agonists may worsen exercise-induced bronchoconstriction and reduce their effectiveness. This suggests short-acting beta-agonist therapy should not be a regular asthma treatment.

Area of Science:

  • Pulmonology
  • Pharmacology

Background:

  • Exercise-induced bronchoconstriction (EIB) is a common condition.
  • Beta-agonists are frequently used for EIB treatment.

Purpose of the Study:

  • To investigate the effect of regular inhaled beta-agonist use on EIB.
  • To assess the bronchodilator response to beta-agonists after regular pretreatment.

Main Methods:

  • A randomized, double-blind, crossover study involving eight subjects with EIB.
  • Subjects received either salbutamol (200 microg qid) or placebo for one week.
  • Exercise challenge was performed 8 hours after the last dose, followed by post-exercise bronchodilator administration.

Main Results:

  • One week of regular salbutamol pretreatment significantly increased the fall in forced expiratory volume in 1 second (FEV1) post-exercise.

Related Experiment Videos

  • FEV1 remained lower during the salbutamol pretreatment arm compared to placebo, even after post-exercise salbutamol administration.
  • The suboptimal response to post-exercise bronchodilator treatment persisted for at least 25 minutes.

    • Conclusions:

    • Regular beta-agonist treatment can exacerbate EIB and lead to a diminished bronchodilator response.
    • This suggests that regular short-acting beta-agonist use may impair emergency treatment response in asthma.
    • Current guidelines advising against regular short-acting beta-agonist therapy for asthma are supported by these findings.