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Methacholine challenge testing: comparative pharmacology

Standardization of the methacholine inhalation challenge, the most common direct bronchoprovocation test, is important. One aspect of standardization is the appropriate washout period for pharmacologic agents which affect the response. This review summarizes the available data on pharmacologic inhib...

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Autores principales: Davis, Beth E, Blais, Christianne M, Cockcroft, Donald W
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5957064/
https://www.ncbi.nlm.nih.gov/pubmed/29785128
http://dx.doi.org/10.2147/JAA.S160607
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author Davis, Beth E
Blais, Christianne M
Cockcroft, Donald W
author_facet Davis, Beth E
Blais, Christianne M
Cockcroft, Donald W
author_sort Davis, Beth E
collection PubMed
description Standardization of the methacholine inhalation challenge, the most common direct bronchoprovocation test, is important. One aspect of standardization is the appropriate washout period for pharmacologic agents which affect the response. This review summarizes the available data on pharmacologic inhibition of the methacholine response. Specific (anti-muscarinic) agents demonstrate marked bronchoprotection (up to 7 days for the long-acting drugs) which lasts longer than the duration of bronchodilation. The functional antagonist (beta 2 agonist class of medications) shows marked, but less, bronchoprotection which is relatively short lived and is similar to the duration of bronchodilator efficacy. Tolerance develops quickly, especially to the long-acting agents. Single doses of controller medications, such as inhaled corticosteroids (ICS) and leukotriene receptor antagonists, have no effect on the methacholine test, while regular use, at least for ICS, has a modest protective effect whose duration is uncertain and likely variable. Theophylline has a small effect and H1 blockers (all generations) have a negligible effect.
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spelling pubmed-59570642018-05-21 Methacholine challenge testing: comparative pharmacology Davis, Beth E Blais, Christianne M Cockcroft, Donald W J Asthma Allergy Review Standardization of the methacholine inhalation challenge, the most common direct bronchoprovocation test, is important. One aspect of standardization is the appropriate washout period for pharmacologic agents which affect the response. This review summarizes the available data on pharmacologic inhibition of the methacholine response. Specific (anti-muscarinic) agents demonstrate marked bronchoprotection (up to 7 days for the long-acting drugs) which lasts longer than the duration of bronchodilation. The functional antagonist (beta 2 agonist class of medications) shows marked, but less, bronchoprotection which is relatively short lived and is similar to the duration of bronchodilator efficacy. Tolerance develops quickly, especially to the long-acting agents. Single doses of controller medications, such as inhaled corticosteroids (ICS) and leukotriene receptor antagonists, have no effect on the methacholine test, while regular use, at least for ICS, has a modest protective effect whose duration is uncertain and likely variable. Theophylline has a small effect and H1 blockers (all generations) have a negligible effect. Dove Medical Press 2018-05-14 /pmc/articles/PMC5957064/ /pubmed/29785128 http://dx.doi.org/10.2147/JAA.S160607 Text en © 2018 Davis et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Davis, Beth E
Blais, Christianne M
Cockcroft, Donald W
Methacholine challenge testing: comparative pharmacology
title Methacholine challenge testing: comparative pharmacology
title_full Methacholine challenge testing: comparative pharmacology
title_fullStr Methacholine challenge testing: comparative pharmacology
title_full_unstemmed Methacholine challenge testing: comparative pharmacology
title_short Methacholine challenge testing: comparative pharmacology
title_sort methacholine challenge testing: comparative pharmacology
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5957064/
https://www.ncbi.nlm.nih.gov/pubmed/29785128
http://dx.doi.org/10.2147/JAA.S160607
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