Document Detail

Is there a problem with inhaled long-acting beta-adrenergic agonists?
MedLine Citation:
PMID:  16387577     Owner:  NLM     Status:  MEDLINE    
Short-acting beta(2)-agonists are effective in relieving acute symptoms of asthma and in the short-term prevention of symptoms from stimuli, such as exercise. They are ineffective when used on a regular schedule to improve asthma control. Long-acting beta(2)-agonists, on the other hand, provide sustained bronchodilation and improve asthma control. Regular use of long-acting beta(2)-agonists is not associated with significant tolerance to their bronchodilator action, impairment in the response to albuterol, decreased baseline pulmonary function, increased response to methacholine, or increased risk of adverse cardiac events. Case-control studies do not suggest an increased risk for death or intensive care unit admissions with use of long-acting beta(2)-agonists. In prospective studies in which there has been an increase in asthma deaths or serious asthma exacerbations, this increased risk has not been observed in subjects using inhaled corticosteroids. Where increased deaths have occurred in relation to either short- or long-acting beta(2)-agonists, the events have not occurred equally throughout the exposed population. This suggests that these outcomes were not a direct toxic effect of the drugs and increases the possibility that they resulted from an interaction between relief of symptoms by beta(2)-agonists and delay in seeking medical care.
Harold S Nelson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  The Journal of allergy and clinical immunology     Volume:  117     ISSN:  0091-6749     ISO Abbreviation:  J. Allergy Clin. Immunol.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-02     Completed Date:  2006-02-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1275002     Medline TA:  J Allergy Clin Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3-16; quiz 17     Citation Subset:  AIM; IM    
National Jewish Medical and Research Center, Denver, CO 80206, USA.
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MeSH Terms
Administration, Inhalation
Adrenergic beta-Agonists / administration & dosage,  adverse effects*
Asthma / drug therapy*,  mortality
Bronchodilator Agents / administration & dosage,  adverse effects
Clinical Trials as Topic
Forced Expiratory Volume / drug effects
Heart / drug effects
Prospective Studies
Receptors, Adrenergic, beta-2 / agonists*,  genetics
Retrospective Studies
Reg. No./Substance:
0/Adrenergic beta-Agonists; 0/Bronchodilator Agents; 0/Receptors, Adrenergic, beta-2
Comment In:
J Allergy Clin Immunol. 2007 Mar;119(3):759; author reply 759-60   [PMID:  17336622 ]

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