Os broncodilatadores na asma: a arte de prescrever corretamente, aproveitando as qualidades e reduzindo os riscos

Abstract

EditorialThe history of the development of bronchodilators of the β 2 -agonist group, which evolved concomitantly with the understanding of the physiopathology of asthma, is an excellent example of how scientific thinking develops, based on hypotheses that comprise partial truths and are progressively filtered in order to improve the understanding of something that should occur, but sometimes does not. Failures are discovered from these continuous observations, and we evolve toward a new generation of intervention, in an attempt to determine the ideal treatment. Formoterol, a long-acting β 2 -agonist (LA β 2 ), is analyzed in this issue of the Brazilian Journal of Pulmonology regarding its efficacy in reversing methacholine-induced bronchospasm. The study compared formoterol with a short-acting β2-agonist (SA β 2 ), fenoterol, demonstrating the equivalence of action of formoterol with one of the drugs considered the gold standard for reversibility of severe bronchospasm, the shortacting bronchodilators. The study population was selected from patients who sought diagnostic clarification of their respiratory symptoms at the pulmonary function laboratory. The patients who tested positive on the provocation test were included in the study.(1)The study protocol allows us to clearly observe that the initial speed of action of the LA β 2 is equivalent to that of the SA β 2 , demonstrating a truth that has come to stay: formoterol, in addition to being devised as long-acting, also has the property we seek, which is to promptly relieve severe bronchospasm, and presents a great advantage over salmeterol. This allows us to advocate its use in severe bronchospasm.