[Types of bronchial reaction to analgesics]

Bronchial reaction of asthma bronchiale patients (n = 102) to analgesics was tested by oral exposure to acetylsalicylic acid. 73 patients produced no changed bronchial response to the exposure test. Ventilation parameters improved in 12 patients. In cases in which analgesics intolerance had been recordable from case histories (n = 17), acetylsalicylic acid doses were carefully increased in a stepwise approach to identify the threshold dose required for inset of bronchoconstriction. The average triggering threshold dose was found to be 200 mg. In patients with normal analgesics tolerance products of arachidonic acid metabolism seem to have no effect on bronchial tonus. The observed dilating effect of analgesics may, possibly, be associated with elimination of a cyclooxygenase metabolite with relevance to bronchoconstriction. Inducer of analgesics intolerance is the shift of arachidonic acid metabolism in favour of the route of lipoxygenase. Of importance is possibly a free proteolytic activity (inhibitor deficiency) with increased basic release of arachidonic acid.