Related Experiment Videos
Should anticholinergics be used in acute severe asthma?
DICP : the Annals of Pharmacotherapy
|April 1, 1990
Summary
Anticholinergic drugs offer modest bronchodilation for acute severe asthma, particularly when combined with beta 2-agonists. These agents are best used as second-line treatments for asthma exacerbations.
Area of Science:
- Pharmacology
- Respiratory Medicine
- Clinical Trials
Background:
- Anticholinergic drugs have a long history in asthma treatment.
- Recent studies explore their efficacy in acute severe asthma.
- Their mechanism involves inhibiting cholinergic-mediated bronchospasm.
Purpose of the Study:
- To critically review clinical trials on anticholinergics in acute severe asthma.
- To evaluate their efficacy and optimal use in this condition.
Main Methods:
- Review of 18 clinical trials focusing on design and endpoints.
- Analysis of anticholinergic efficacy alone and in combination with beta 2-agonists.
Main Results:
- Anticholinergics provide modest bronchodilation alone, less consistent than beta 2-agonists.
- Consistent added bronchodilation observed when combined with beta 2-agonists.
- Greater effect seen in severely obstructed patients, though overall outcome benefit is unproven.
Conclusions:
- Anticholinergics are second-line agents for acute severe asthma.
- Quaternary amine derivatives are currently recommended.
- Consideration for severely obstructed patients (PEFR < 35% predicted) may warrant their use.