Reversion of methacholine induced bronchoconstriction with inhaled diazepam in patients with asthma

Abril 2016

ARTÍCULOS DE INVESTIGACIÓN 434 Rev Med Chile 2016; 144: 434-441 1Medical Faculty of the University in Pristina with temporary seat in Kosovska Mitrovica, Kosovo, Serbia, Department of pathological physiology. 2Medical faculty Foca, University of East Sarajevo, Republic of Srpska, Bosnia and Herzegovina, Department of physiology. 3Medical Faculty Foca, University of East Sarajevo, Republic of Srpska, Bosnia and Herzegovina, Department of pathological physiology. 4Medical Faculty Foca, University of East Sarajevo, Republic of Srpska, Bosnia and Herzegovina. Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Recibido el 27 de abril de 2015, aceptado el 27 de enero de 2016. Corresponding author: Mirjana Miric, MD, PhD, University in Pristina with temporary seat in Kosovska Mitrovica, Kosovo, Serbia. Adress: Zoran Glodic (za Bojana Joksimovića), Ul Maka Dizdara br. 8, 73 300 Foca, Republic of Srpska, Bosnia and Herzegovina. Phone: 0038765373507 joksimovic_bojan@yahoo.com Reversion of methacholine induced bronchoconstriction with inhaled diazepam in patients with asthma MIRJANA MIRIC1,3, SINISA RISTIC2, BOJAN N. JOKSIMOVIC3, SNEZANA MEDENICA4, MAJA RACIC4, SLAVICA RISTIC4, VEDRANA R. JOKSIMOVIC4, MIRJANA SKIPINA4 ABSTRACT Background: Benzodiazepines have a direct bronchodilatory effect. Methacholine is a non-selective muscarinic receptor agonist causing bronchoconstriction. Aim: To examine the effects of inhaled benzodiazepines, modulating bronchoconstriction induced by methacholine in patients with asthma. Patients and Methods: Twelve patients with well controlled asthma were studied. On the first day, after determining the initial values of pulmonary function, a dose response curve was carried out with progressive doses of methacholine. After the last dose, when at least a 20% drop of the initial forced expiratory volume in the first second (FEV1) was achieved, vital capacity (VC) and FEV1 were measured at 7, 15 and 30 minutes after provocation. On the second day a diazepam aerosol was inhaled by the patients prior to the same protocol with methacholine. Results: In the first day of testing, methacholine inhalation (6 mg/mL) led to a significant drop in FEV1 from 2.98 to 1.69 L. On the second day of study, in the same patients, previous inhalation with diazepam reduced the changes of FEV1 after inhalation of methacholine. This parameter decreased from 2.48 to 2.21 L. Conclusions: Inhalation of benzodiazepines reduce bronchoconstriction after a methacholine challenge in patients with asthma. (Rev Med Chile 2016; 144: 434-441) Key words: Benzodiazepines; Bronchoconstriction; Diazepam; Methacholine Chloride) Bloqueo de la respuesta bronco constrictora a metacolina con diazepam inhalado en pacientes con asma Antecedentes: Las benzodiacepinas tienen un efecto broncodilatador directo. La metacolina es un agonista muscarínico que causa bronco constricción. Objetivo: Evaluar el efecto modulador de la inhalación de diazepam sobre la bronco constricción inducida por metacolina. Pacientes y Métodos: Se estudiaron 12 pacientes con asma bien controlada. En el primer día, se determinó la curva dosis respuesta de parámetros de función pulmonar a una dosis progresiva de metacolina. Después de la última dosis, cuando se consiguió un 20% de reducción en la capacidad vital forzada en el primer segundo (FEV1), se midió FEV1 y la capacidad vital (CV) a los 7, 15 y 30 min después de la provocación. En el


Abril 2016
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