Effect of Intravenous Prednisolone in Asthmatics With Diminished Adrenergic Responsiveness

Ellul-Micallef, Roger; Fenech, Frederick F.

doi:10.1016/s0140-6736(75)90608-x

Cited by 142 publications

(35 citation statements)

References 12 publications

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“…Hemisuccinate or phosphate salts of glucocorticoids such as prednisolone and dexamethasone are useful in the treatment of asthma (Collins, Harris, Clark & Townsend, 1970;Ellul-Micallef & Fenech, 1975;Ellul-Micallef, Borthwick & McHardy, 1980). However, massive concentrations of these steroids failed to increase more than marginally the sensitivity of pig isolated bronchus to Iso.…”

Section: Discussionmentioning

confidence: 99%

Effect of steroids on β‐adrenoceptor‐mediated relaxation of pig bronchus

Foster

Goldie

Paterson

1983

British J Pharmacology

111

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Section: Discussionmentioning

confidence: 99%

Effect of steroids on β‐adrenoceptor‐mediated relaxation of pig bronchus

Foster

Goldie

Paterson

1983

British J Pharmacology

111

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“…The latter is standardized for lung volume by expressing the result as specific airways conductance. In some asthmatic subjects an acute response to a bronchodilator may be revealed only after a short course of steroids (possibly by restoring ~2-responsiveness in pre~iously non-responsive asthmatics [204]), which may b~' itself change baseline lung functjon; this needs to be l&:lked ilitQ further. Indices of forced expiratory flow can be in e;ror if the lung volume chang~ during the assessment.…”

Section: Assessment Of the Response To Bronchodilator Drugsmentioning

confidence: 99%

Lung volumes and forced ventilatory flows

Quanjer¹,

Tammeling²,

Cotes³

et al. 1993

Eur Respir J

4,610

982

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“…Besides, the glucocortiasthmatic subjects with either placebo, 250, 500 coids seem able to potentiate the action of betaor 1000 mg hydrocortisone intravenously, fol-adrenergic agents. It is a common clinical oblowed by inhalation of isoprenaline at hourly servation that the severely affected asthmatic intervals for 6 h. No difference was found in patient who does not respond to the beta agothe course of the four groups, who were fol-nists, may regain responsiveness during glucolowed with measurements of forced expiratory corticoid treatment (3,34,120). Normal subjects volumes and of airway resistance and conduct-with an induced resistance to beta agonists may ance in a body plethysmograph.…”

Section: Intravenous Aminophylline and Intravenousmentioning

confidence: 99%

The Treatment of Status Asthmaticus

Georg

1981

Allergy

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Asthma has proved difficult to define (42, 103, in asthma often comes suddenly and unexpect-116) and physicians do not always agree about edly, and even experienced physicians may when a patient should be called asthmatic, have difficulty in judging the severity of an Status asthmaticus cannot be easier to define, attack. The patient may be a better judge in but it seems much more seldom that physicians this respect (122), but many asthmatics are not disagree about a diagnosis of status asthma-very sensitive to changes in airway obstruction, ticus. The term will be used here to denote a Rubinfeld & Pain (111) found that 15% were sustained attack of severe asthma that has not unable to sense a reduction in FEVj below 50% responded to the treatment administered by of predicted value. An objective assessment the patient and his doctor. It is a serious and ought usually to be the first step taken when potentially lethal phase of the disease and if dealing with a patient in status asthmaticus. It hospital admission is possible it will usually be can be carried out in a few minutes, and it required.provides both a baseline from which the proStatus asthmaticus is an acute aggravation gress of the patient can be assessed and a gradwhich may afflict the allergic as well as the ing of the severity of the attack, non-allergic asthmatic. It may occur at any age.The physical signs of wheezing, the use of but the risk seems to be greatest in the middle-accessory respiratory muscles and the presence aged patient with asthma of late onset. It also of pulsus paradoxus have not been found to be seems to afflict women more often than men. reliable indicators of the severity of asthma (71, In seven recent papers (7,25,58,61,70,118,121). 119) out of a total of 1,540 patients, 1,136 were Counting the heart rate is the simplest of females and 404 males, i.e. a ratio of about 3:1.objective measurements and will provide some We have now fairly good knowledge of the indication of the severity of the attack. An elecliberation of mediator substances from the trocardiogram and a chest radiograph should mast cell in the reaction with specific allergens also be available. Tachycardia is always a feature and about their possible significance in acute, of severe asthma and is related to the degree of asthmatic attacks. Yet we do not understand hypoxaemia (107). The average heart rate is what happens when the patient lapses into about [120][121][122][123][124][125][126][127][128][129][130] found an average status asthmaticus despite the use of the medi-rate of 126; Westerman (137) 139 with a range cation which in other situations has successfully from 110 to 180; Rees (107) 118, range 96-160. brought him relief Cooke et al. (25) found a heart rate above 90 in 87% of their patients and that 75% of the complications occurred in patients with a heart Objective assessment ^ , ,0•^ rate above 130. The treatment of severe asthma must reasonTwo important objective measurements that ably begin with an assessment of severity. Death any emergency ward s...

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Effect of Intravenous Prednisolone in Asthmatics With Diminished Adrenergic Responsiveness

Cited by 142 publications

References 12 publications

Effect of steroids on β‐adrenoceptor‐mediated relaxation of pig bronchus

Effect of steroids on β‐adrenoceptor‐mediated relaxation of pig bronchus

Lung volumes and forced ventilatory flows

The Treatment of Status Asthmaticus

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