Methacholine challenge testing: comparative pharmacology

Davis, Beth E.; Blais, Christianne M.; Cockcroft, Donald W.

doi:10.2147/jaa.s160607

Cited by 20 publications

(15 citation statements)

References 58 publications

(76 reference statements)

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“…Table 8 lists suggested withholding times for various bronchodilators. The withholding times are based on studies of the lasting bronchodilator effects of the various agents ( 93 , 94 ). Inhaled corticosteroids and leukotriene modifiers need not be withheld.…”

Section: Bronchodilator Responsiveness Testingmentioning

confidence: 99%

Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement

Graham¹,

Steenbruggen²,

Miller³

et al. 2019

Am J Respir Crit Care Med

2,472

1,736

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Background: Spirometry is the most common pulmonary function test. It is widely used in the assessment of lung function to provide objective information used in the diagnosis of lung diseases and monitoring lung health. In 2005, the American Thoracic Society and the European Respiratory Society jointly adopted technical standards for conducting spirometry. Improvements in instrumentation and computational capabilities, together with new research studies and enhanced quality assurance approaches, have led to the need to update the 2005 technical standards for spirometry to take full advantage of current technical capabilities. Methods: This spirometry technical standards document was developed by an international joint task force, appointed by the American Thoracic Society and the European Respiratory Society, with expertise in conducting and analyzing pulmonary function tests, laboratory quality assurance, and developing international standards. A comprehensive review of published evidence was performed. A patient survey was developed to capture patients’ experiences. Results: Revisions to the 2005 technical standards for spirometry were made, including the addition of factors that were not previously considered. Evidence to support the revisions was cited when applicable. The experience and expertise of task force members were used to develop recommended best practices. Conclusions: Standards and consensus recommendations are presented for manufacturers, clinicians, operators, and researchers with the aims of increasing the accuracy, precision, and quality of spirometric measurements and improving the patient experience. A comprehensive guide to aid in the implementation of these standards was developed as an online supplement.

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Section: Bronchodilator Responsiveness Testingmentioning

confidence: 99%

Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement

Graham¹,

Steenbruggen²,

Miller³

et al. 2019

Am J Respir Crit Care Med

2,472

1,736

View full text Add to dashboard Cite

show abstract

“…It is a cholinergic agonist that acts on muscarinic receptors, mainly subtype M3 coupled to G protein, promoting a cascade of events that lead to the recruitment of calcium with consequent contraction of smooth muscle. 55 The contraction of airway smooth muscle promotes a decrease in diameter with a consequent increase in airway resistance. 55 MCh differs from ACh in terms of action time and selectivity, and it is degraded more slowly by acetylcholinesterase.…”

Section: Methacholinementioning

confidence: 99%

“…55 The contraction of airway smooth muscle promotes a decrease in diameter with a consequent increase in airway resistance. 55 MCh differs from ACh in terms of action time and selectivity, and it is degraded more slowly by acetylcholinesterase. In humans, MCh is often used in spirometry tests.…”

Section: Methacholinementioning

confidence: 99%

Drug class effects on respiratory mechanics in animal models: access and applications

Oliveira

Lino-Alvarado

Moriya

et al. 2021

Exp Biol Med (Maywood)

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Assessment of respiratory mechanics extends from basic research and animal modeling to clinical applications in humans. However, to employ the applications in human models, it is desirable and sometimes mandatory to study non-human animals first. To acquire further precise and controlled signals and parameters, the animals studied must be further distant from their spontaneous ventilation. The majority of respiratory mechanics studies use positive pressure ventilation to model the respiratory system. In this scenario, a few drug categories become relevant: anesthetics, muscle blockers, bronchoconstrictors, and bronchodilators. Hence, the main objective of this study is to briefly review and discuss each drug category, and the impact of a drug on the assessment of respiratory mechanics. Before and during the positive pressure ventilation, the experimental animal must be appropriately sedated and anesthetized. The sedation will lower the pain and distress of the studied animal and the plane of anesthesia will prevent the pain. With those drugs, a more controlled procedure is carried out; further, because many anesthetics depress the respiratory system activity, a minimum interference of the animal’s respiration efforts are achieved. The latter phenomenon is related to muscle blockers, which aim to minimize respiratory artifacts that may interfere with forced oscillation techniques. Generally, the respiratory mechanics are studied under appropriate anesthesia and muscle blockage. The application of bronchoconstrictors is prevalent in respiratory mechanics studies. To verify the differences among studied groups, it is often necessary to challenge the respiratory system, for example, by pharmacologically inducing bronchoconstriction. However, the selected bronchoconstrictor, doses, and administration can affect the evaluation of respiratory mechanics. Although not prevalent, studies have applied bronchodilators to return (airway resistance) to the basal state after bronchoconstriction. The drug categories can influence the mathematical modeling of the respiratory system, systemic conditions, and respiratory mechanics outcomes.

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“…7 ► Not consume alcohol for at least 4 hours prior to the test. Reproduced from Davis et al 21 ICS, inhaled corticosteroids; LABA, long-acting beta-agonist; LAMA, long-acting muscarinic antagonist; SABA, short-acting beta-agonist; SAMA, short-acting muscarinic antagonist; uLABA, ultra-long-acting beta-agonist.…”

Section: General Proceduresmentioning

confidence: 99%

“…By studying airway smooth muscle contraction using methacholine challenge testing, Davis et al 21 showed the relative duration of bronchoprotection for a variety of commonly used respiratory medications. This gives some guide for the appropriate withhold times to establish clearance of these medications prior to testing when a baseline test (ie, without the support of medication) is required.…”

Section: General Proceduresmentioning

confidence: 99%

ARTP statement on pulmonary function testing 2020

et al. 2020

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The Association for Respiratory Technology & Physiology (ARTP) last produced a statement on the performance of lung function testing in 1994. At that time the focus was on a practical statement for people working in lung function laboratories. Since that time there have been many technological advances and alterations to best practice in the measurement and interpretation of lung function assessments. In light of these advances an update was warranted. ARTP, therefore, have provided within this document, where available, the most up-to-date and evidence-based recommendations for the most common lung function assessments performed in laboratories across the UK. These recommendations set out the requirements and considerations that need to be made in terms of environmental and patient factors that may influence both the performance and interpretation of lung function tests. They also incorporate procedures to ensure quality assured diagnostic investigations that include those associated with equipment, the healthcare professional conducting the assessments and the results achieved by the subject. Each section aims to outline the common parameters provided for each investigation, a brief principle behind the measurements (where applicable), and suggested acceptability and reproducibility criteria.

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Methacholine challenge testing: comparative pharmacology

Cited by 20 publications

References 58 publications

Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement

Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement

Drug class effects on respiratory mechanics in animal models: access and applications

ARTP statement on pulmonary function testing 2020

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