Bronchodilators and Corticosteroids in Asthma

Hume, K.M.; Jones, E. Rhys

doi:10.1016/s0140-6736(60)92518-6

Cited by 25 publications

(4 citation statements)

References 3 publications

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“…The apparent effectiveness of a bronchodilator drug depends on the degree of airway obstruction present before it is administered (Hume and Jones, 1960;Pain and Read, 1963). In asthmatic patients the great variation in airway obstruction from day to day and during the course of a single day (Minette, 1964) drugs extremely difficult.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Cardiorespiratory Effects of Isoprenaline and Salbutamol in Patients with Bronchial Asthma

Warrell¹,

Robertson²,

Howes³

et al. 1970

BMJ

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Summary: The effects of isoprenaline and salbutamol administered orally, by inhalation, or by intravenous infusion were compared in 13 asthmatic patients. Bronchodilator activity was assessed by serial measurement of specific airways conductance (SGaw). Log-dose response curves were obtained for both drugs and showed them to be equipotent as bronchodilators. Cardiovascular effects were variable, but in general, isopenaline caused greater rise in pulse rate and a greater change in blood pressure than the same dose of salbutamol.Cardiorespiratory measurements during continuous intravenous infusion of increasing doses of both drugs suggested a greater effect of isoprenaline than the same dose of salbutamol on metabolic rate, pulmonary ventilation, pulmonary gas exchange, cardiac output, and heart rate. The effect of salbutamol on the heart rate was about 10 times less than that of isoprenaline but lasted longer.

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Section: Discussionmentioning

confidence: 99%

Comparison of Cardiorespiratory Effects of Isoprenaline and Salbutamol in Patients with Bronchial Asthma

Warrell¹,

Robertson²,

Howes³

et al. 1970

BMJ

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“…It has long been recognized that the apparent efficacy of a bronchodilator is related to the degree of airways obstruction present before it is administered (Hume and Gandevia, 1957;Hume and Rhys Jones, 1961). This would seem to be a simple relationship, but unfortunately several factors complicate it.…”

Section: Discussionmentioning

confidence: 99%

Effects of Salbutamol and Isoprenaline Phenylephrine in Reversible Airways Obstruction

Alliott¹,

Lang²,

Rawson³

et al. 1972

BMJ

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S39 examination showed delayed gastric emptying with a lesser curve gastric ulcer. Acid secretory studies showed no response to insulin, indicating a complete vagotomy. At reoperation, eight months after the first operation, a lesser curve gastric ulcer was present but no duodenal ulcer. He is now well after antrectomy.Case 3.-An insulin test was negative three months after vagotomy in a man aged 37. After one year he developed epigastric pain and vomiting and barium meal examination showed a lesser curve gastric ulcer with normal gastric emptying. The ulcer was confirmed by gastroscopy. Conservative treatment of the ulcer was undertaken and further gastroscopy showed that the ulcer was healing. Fourteen months after the operation and two months after the development of a gastric ulcer a barium meal examination showed an apparently normal stomach which still emptied normally. He was then symptom-free. DiscussionThe idea of treating patients with duodenal ulceration by vagotomy without a drainage operation is attractive and has been the goal of many surgeons. Dragstedt and Owens (1943) Jrournal, 1972, 1, 539-542 Summary Ventolin (salbutamol) and Medihaler-Duo (isoprenaline/ phenylephrine combination) standard pressurized inhalers were used to administer doses of two or six "puffs" to 16 patients with known reversible airways obstruction.The doses were administered in random order over two days. Both the Ventolin and Medihaler-Duo inhalers substantially increased FEV1, but in the doses used salbutamol was more effective than isoprenaline/phenylephrine (P < 001). There was no significant difference between two and six puffs of salbutamol, though there seemed to be an advantage of six puffs of isoprenaline/ phenylephrine over two puffs (P < 0 05). Adrenaline (1/1,000) 0 5 ml and atropine 0 6 mg produced similar increases in FEV1 to those produced by salbutamol.County Hospital, Hereford R.

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“…Why was there such a poor relationship between the practitioners' diagnoses or the symptomatic "predicted" diagnoses and the bronchodilator reversibility? Hume and Rhys- Jones (1960) . Unfortunately it is not known whether patients with chronic bronchitis respond to a similar degree with higher doses of^2 stimulants as those with asthma.…”

Section: The R E L a T I O N S H I Pbmentioning

confidence: 99%

The diagnosis and treatment of adults with obstructive airways disease in general practice

Wardman

Binns

Clayden

et al. 1986

British Journal of Diseases of the Chest

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Two hundred and one patients diagnosed by their general practitioners as having asthma and 113 as having chronic bronchitis were compared by symptomatology and airways reversibility. Though the majority of patients given these two diagnoses could be separated by symptom complex, in about one-third such differentiation was difficult. There was no significant difference in bronchodilator reversibility between the asthmatics and chronic bronchitics. Nine out of 15 (60%) asthmatics and four out of 18 (22%) chronic bronchitics responded by 15% or more to a course of oral corticosteroid drugs. The majority of corticosteroid responders had been undertreated. The problems arising from the poor correlation between airways reversibility and symptomatic diagnosis are discussed.

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Bronchodilators and Corticosteroids in Asthma

Cited by 25 publications

References 3 publications

Comparison of Cardiorespiratory Effects of Isoprenaline and Salbutamol in Patients with Bronchial Asthma

Comparison of Cardiorespiratory Effects of Isoprenaline and Salbutamol in Patients with Bronchial Asthma

Effects of Salbutamol and Isoprenaline Phenylephrine in Reversible Airways Obstruction

The diagnosis and treatment of adults with obstructive airways disease in general practice

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