A Comparison of Lung Function Methods for Assessing Dose-response Effects of Salbutamol

Overview

Journal Br J Clin Pharmacol

Specialty Pharmacology

Date 2004 Jul 17

PMID 15255795

Citations 28

Authors

Catherine M Houghton

Ashley A Woodcock

Dave Singh

Affiliations

Soon will be listed here.

Abstract

Pulmonary function methods which are able to detect small pharmacological effects may be useful for assessing the full dose-response curve of bronchodilatators. We compared the ability of impulse oscillometry (R5, R20, X5, RF), plethysmography (sGaw) and spirometry [forced expiratory volume in 1 s (FEV(1)), maximal mid expiratory flow rate (MMEF)] to measure the dose-response effects of salbutamol in 12 healthy subjects, 12 mild asthmatics (mean FEV(1) 96% predicted) and 12 moderate asthmatics (mean FEV(1) 63% predicted). The techniques were performed twice to assess variability. Then salbutamol 10, 20, 100, 200 and 800 microg was administered. The sensitivity of the methods were compared by determining the lowest dose that caused changes greater than variability. In healthy subjects significant changes (p < or = 0.05) were observed only in FEV(1) (4.1%) and MMEF (14.6%) at 100 microg and sGaw (25.6%) and R20 (8.3%) at 200 microg. In mild asthmatics significant changes were observed in sGaw (15.9%) at 10 microg, X5 (23%), RF (20.3%) and MMEF (15.7%) at 20 microg, R5 (13.9%) and R20 (9.4%) at 100 microg and FEV(1) (7.1%) at 200 microg. All measurements except R20 demonstrated significant changes at 10 micro g in moderate asthmatics. The most sensitive test for assessing bronchodilatation is different in healthy subjects and asthmatics, and varies with severity of airflow obstruction.

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References

Burns G, Gibson G . A novel hypothesis to explain the bronchconstrictor effect of deep inspiration in asthma. Thorax. 2002; 57(2):116-9. PMC: 1746262. DOI: 10.1136/thorax.57.2.116. View

Hellinckx J, Cauberghs M, De Boeck K, Demedts M . Evaluation of impulse oscillation system: comparison with forced oscillation technique and body plethysmography. Eur Respir J. 2001; 18(3):564-70. DOI: 10.1183/09031936.01.00046401. View

Sjosward K, Josefsson M, Ahlner J, Schmekel B . Preserved bronchial dilatation after salbutamol does not guarantee protection against bronchial hyperresponsiveness. Clin Physiol Funct Imaging. 2003; 23(1):14-20. DOI: 10.1046/j.1475-097x.2003.00462.x. View

Malmberg L, Pelkonen A, Haahtela T, Turpeinen M . Exhaled nitric oxide rather than lung function distinguishes preschool children with probable asthma. Thorax. 2003; 58(6):494-9. PMC: 1746693. DOI: 10.1136/thorax.58.6.494. View

Skinner C, PALMER K . Changes in specific airways conductance and forced expiratory volume in one second after a bronchodilator in normal subjects and patients with airways obstruction. Thorax. 1974; 29(5):574-7. PMC: 470202. DOI: 10.1136/thx.29.5.574. View

Light R, Conrad S, George R . The one best test for evaluating the effects of bronchodilator therapy. Chest. 1977; 72(4):512-6. DOI: 10.1378/chest.72.4.512. View

Gribbin H, Baldwin C, Tattersfield A . Quantitative assessment of bronchial beta-adrenoceptor blockade in man. Br J Clin Pharmacol. 1979; 7(6):551-6. PMC: 1429682. DOI: 10.1111/j.1365-2125.1979.tb04641.x. View

Tattersfield A, Keeping I . Assessing change in airway calibre--measurement of airway resistance. Br J Clin Pharmacol. 1979; 8(4):307-19. PMC: 1429850. DOI: 10.1111/j.1365-2125.1979.tb04711.x. View

Wouters E, Quaedvlieg M, Mostert R, Polko A, VISSER B . Localization of bronchial response to ipratropium bromide by respiratory impedance measurement in asthmatics. Int J Clin Pharmacol Ther Toxicol. 1989; 27(3):145-9. View

10.

Neild J, Twort C, Chinn S, McCormack S, Jones T, Burney P . The repeatability and validity of respiratory resistance measured by the forced oscillation technique. Respir Med. 1989; 83(2):111-8. DOI: 10.1016/s0954-6111(89)80224-0. View

11.

van den Elshout F, Van de Woestijne K, Folgering H . Variations of respiratory impedance with lung volume in bronchial hyperreactivity. Chest. 1990; 98(2):358-64. DOI: 10.1378/chest.98.2.358. View

12.

Demedts M . Precise diagnosis of airflow obstruction - does it matter for treatment? The assessment of reversibility: what physiological tests?. Eur Respir J. 1990; 3(9):1084-7. View

13.

Chinn S . Statistics in respiratory medicine. 2. Repeatability and method comparison. Thorax. 1991; 46(6):454-6. PMC: 463197. DOI: 10.1136/thx.46.6.454. View

14.

van Noord J, Smeets J, Clement J, Van de Woestijne K, Demedts M . Assessment of reversibility of airflow obstruction. Am J Respir Crit Care Med. 1994; 150(2):551-4. DOI: 10.1164/ajrccm.150.2.8049845. View

15.

Mazurek H, Marchal F, Derelle J, Hatahet R, Monin P . Specificity and sensitivity of respiratory impedance in assessing reversibility of airway obstruction in children. Chest. 1995; 107(4):996-1002. DOI: 10.1378/chest.107.4.996. View

16.

Bouaziz N, Beyaert C, Gauthier R, Monin P, Peslin R, Marchal F . Respiratory system reactance as an indicator of the intrathoracic airway response to methacholine in children. Pediatr Pulmonol. 1996; 22(1):7-13. DOI: 10.1002/(SICI)1099-0496(199607)22:1<7::AID-PPUL2>3.0.CO;2-P. View

17.

van Noord J, Smeets J, Raaijmakers J, Bommer A, MAESEN F . Salmeterol versus formoterol in patients with moderately severe asthma: onset and duration of action. Eur Respir J. 1996; 9(8):1684-8. DOI: 10.1183/09031936.96.09081684. View

18.

Schmekel B, Smith H . The diagnostic capacity of forced oscillation and forced expiration techniques in identifying asthma by isocapnic hyperpnoea of cold air. Eur Respir J. 1997; 10(10):2243-9. DOI: 10.1183/09031936.97.10102243. View

19.

Kaczka D, Ingenito E, Israel E, Lutchen K . Airway and lung tissue mechanics in asthma. Effects of albuterol. Am J Respir Crit Care Med. 1999; 159(1):169-78. DOI: 10.1164/ajrccm.159.1.9709109. View

20.

Delacourt C, Lorino H, Reinert P, Harf A, Housset B . Use of the forced oscillation technique to assess airway obstruction and reversibility in children. Am J Respir Crit Care Med. 2000; 161(3 Pt 1):730-6. DOI: 10.1164/ajrccm.161.3.9904081. View