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Acute bronchodilatory effect of salmeterol on methacholine-induced bronchoconstriction in childhood asthma
1Department of Pediatrics, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Insights
Salmeterol and salbutamol show similar effectiveness in treating acute bronchoconstriction in children with asthma. This study compared their bronchodilatory effects on methacholine-induced airway narrowing in pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Pharmacology
Background:
- Asthma management in children requires effective bronchodilators.
- Research gaps exist regarding salmeterol's acute bronchodilatory effects in pediatric asthma.
- Methacholine challenge is a standard method to assess airway hyperresponsiveness.
Purpose of the Study:
- To evaluate the acute bronchodilatory effect of salmeterol in childhood asthma.
- To compare salmeterol's efficacy against salbutamol in methacholine-induced bronchoconstriction.
- To assess changes in forced expiratory volume in 1 second (FEV1) and oxygen saturation (SaO2).
Main Methods:
- Forty-four children (7-17 years) with mild-to-moderate asthma underwent methacholine challenge testing.
- Baseline FEV1 and SaO2 were measured.
- Subjects received either salmeterol (25 mcg) or salbutamol (100 mcg), with post-inhalation measurements at 5 and 20 minutes.
Main Results:
- Both salmeterol and salbutamol groups showed significant improvements in FEV1 and SaO2 post-inhalation (P < 0.005).
- No significant differences in FEV1 or SaO2 were observed between salmeterol and salbutamol at 5 and 20 minutes (P > 0.05).
- The provocative concentration 20% (PC20) was determined via methacholine challenge.
Conclusions:
- Salmeterol demonstrates comparable acute bronchodilatory effects to salbutamol in pediatric patients with asthma.
- Both medications effectively improved FEV1 and SaO2 following methacholine-induced bronchoconstriction.
- Salmeterol can be considered a viable option for acute bronchodilation in childhood asthma.
Abstract:
A review of the literature highlights the need for research, particularly on the acute bronchodilatory effect of salmeterol on bronchoconstriction in the pediatric age group. The present study attempted to evaluate the acute bronchodilatory effect of salmeterol on methacholine-induced bronchoconstriction in childhood asthma and to compare it with the effect of salbutamol. Forty-four asymptomatic children with mild-to-moderate asthma (23 boys and 21 girls; aged 7-17 years) were studied. At the beginning, the baseline forced expiratory volume in 1 s (FEV1) was measured, and the methacholine challenge was performed by doubling the dose to determine PC20 (provocative concentration of inhaled methacholine required to reduce FEV1 by 20%). At the same time, the transcutaneous arterial oxygen saturation (SaO2) was also measured. Each subject inhaled a single dose of 25 micrograms salmeterol (n: 23, group I) or 100 micrograms salbutamol (n: 21, group II) following the SaO2 measurement. The same measurements (FEV1, SaO2) were repeated 5 and 20 min after the inhalation. After inhalation of salmeterol or salbutamol, the differences between the values of FEV1 and SaO2 after 5 and 20 min were insignificant in both group I and group II (P > 0.05), although there was a significant improvement in both FEV1 and SaO2 after 5 and 20 min (P < 0.005). From these findings it was concluded that salmeterol can be considered as effective as salbutamol on methacholine-induced bronchoconstriction.