[Beta-2 adrenergic stimulants in the treatment of asthma: myths and realities]

In this review paper the authors describe the reasons, sometimes complex, which have given birth to such myths as the abuse of beta 2-stimulants generating status asthmaticus, or patients developing clinical tachyphylaxis to this type of drug. While there is no solid ground to believe that beta 2-stimulants can be blamed for the overmortality due to asthma, and while the indications of beta 2-stimulants delivered by metered-dose aerosols can be extended to chronic asthma, it is still necessary to apply certain safety rules when these drugs are inhaled in high doses or given parenterally. Some patients must be encouraged to use inhaled beta 2-stimulants prophylactically, sometimes combined with cromolyn or inhaled corticosteroids, but these patients, their relatives and their doctor should be taught to evaluate lung function by means of a peak-flow meter. A lack of response to beta 2-stimulants must be taken as a warning that systemic corticosteroids and in some cases admission to hospital are needed.