Four pressurized spray bronchodilator drug preparations and placebo were compared in their ability to inhibit exercise induced asthma in 16 asthmatic children (4 to 12 years old), by measures of the maximum expiratory flow index fall after -free running exercise test. Average flow index fall was 1.96 for fenoterol; 15.31 for ipratropium bromide; 5.21 for salbutamol and -0.47 for the mixture of fenoterol and ipratropium bromide. Thus all four drug preparations were able to inhibit exercise-induced asthma but not placebo (beclomethasone, mean index fall 24.721. The efficacy of ipratropium bromide as a single drug was significantly lower than that of the other preparations.
Seventeen children aged 5 to 11 years old, with exercise induced asthma (EIA) and an average exercise induced fall in their peak expiratory flow (PEF) of 27,5 %, were tested for prevention of EIA with Salbutamol in the aerosol form. The efficacy of the drug when the dosimeter was directly applied into the mouth (standard method) was compared with its indirect application by means of an aerial chamber made of dischargeable plastic bottles for intravenous fluids, modified as to oclude both patient's mouth and nose with one of it's ends and to insert the dosimeter into the other one (alternative method). The decrease in PEF fall was 96,6 %and 99,6% with the standard and the alternative methods respectively; in both cases it was statistically significant j(p ^O.Oll), suggesting the effectiveness of the 'alternative method and supporting our clinical observations in the treatment of wheezing infants. No side effects were observed. El asma tiene alta prevalencia en nuestro pai's 1 ' 2 . El uso de drogas broncodilatadoras por inhalation es el metodo mas efectivo de tratamiento 4 -5 La efectividad de la droga depende de la cantidad inhalada y de su penetration, que a su vez estan determinadas por la tecnica de inhalation empleada 6 ' 7 y por las propiedades fisicas del aerosol 6 -9 -10 .La tecnica de inhalation es particularmente importance en nifios de corta edad 11 -12 , en quienes la principal dificultad consiste en sincronizar la inhalation con la descarga, como ocurre con elempleo de dosificadores apresion 13 ' 14 -Varies autores han propuesto diferentes adaptaciones como bolsas colapsables 15 -16 , tubos de extension bucal 12 ' 17 , aerocamaras 13 -18 -19 , las que no siempre resultan efectjvas pues requieren Un esfuerzo respiratorio exclusivamente bucal y ademas aumentan los costos.Desde hace algun tiempo, en nuestro Servitio se esta utilizando una mascarilla confeccionada con parte de un matraz de suero desechado, de aplicacion buco-nasal, con el proposito de incor- porar a la poblacion mencionada a este tipo de tratamiento, sin.que sus resultados hayan sido comunicados.La mascarilla que proponemos, constituye una verdadera camara aerea para medicamentos envasados a presion (CAMP), que incluye boca y nariz, y teoricamente disminuirian las dificultades de inhalation que presentan algunos pacientes.Este estudio .se disefio para evaluar este metodo alternative, en comparacion con el metodo clasico, midiendo la inhibition de la respuesta bronquial al ejercicio con drogas broncodilatadoras (Salbutamol = Aerolin R ). MATERIAL Y METODOSEl estudio se realize con un grupo de 17 ninos (entre 5 y 11 aftos de edad), que ingresaron a nuestro servicio de enfermedades broncopulmonares, por presentar antecedentes ch'nicos de asma inducida por el ejercicio (AIE), cuyas caracteristicas se presentan en la Tabla 1. En todos los pacientes se demostro AIE mediante una prueba estandar de ejercicio 20 ' 21 , en la que tuvieron indices de caida (1C) 22
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