Time-limited protective effect of inhaled frusemide against aspirin-induced bronchoconstriction in aspirin-sensitive asthmatics

Abstract

Inhaled frusemide effectively prevents the bronchial obstructive response to allergens and to a number of nonallergic stimuli. In most of the experimental models in which it has been tested, the protective effect of frusemide has been evaluated for only a short time after administration. In aspirin-sensitive patients, acetylsalicylic acid causes an asthmatic reaction which typically lasts for 2 h or more after exposure. We investigated the presence and duration of the protective effect of inhaled frusemide against the bronchial response to aspirin in sensitive patients, using a specific inhalation challenge with lysine acetylsalicylate (LASA). In the first study, eight subjects with aspirin-asthma underwent two bronchial challenges with a single dose of lysine acetylsalicylate administered through a jet nebulizer, after treatment with 40 mg inhaled frusemide or placebo, according to a randomized, double-blind protocol. Forced expiratory volume in one second (FEV1) was monitored for 120 min after challenge. In the second study in eight patients, the protocol was modified by the use of a dosimeter for delivery of lysine acetylsalicylate, by reducing the dose of lysine acetylsalicylate to avoid intense reactions, and by extending the follow-up to 4 h. In the first study, after placebo, FEV1 gradually decreased, reaching a maximum decrement of 39 +/- 3% at 120min. Inhaled frusemide exerted a significant protection at all time-points, although this activity appeared to decrease with time. In the second study, after placebo, inhaled lysine acetylsalicylate caused a gradual decrease in FEV1, which reached a maximum decrement at 180 min.(ABSTRACT TRUNCATED AT 250 WORDS)

Nebulized Furosemide as a Novel Treatment for Dyspnea in Terminal Cancer Patients

“…Sestini et al reported that the duration of the effect of inhaled furosemide in aspirin-in-duced bronchial asthma was approximately 2 hours. 11 However, in another report, furosemide had protective effect against allergen-induced asthma up to 12 hours after inhalation. 7 We administered furosemide therapy using the same schedule as the prior orciprenaline therapy, which was a four times a day.…”

Effect of inhalation aspirin challenge on exhaled nitric oxide in patients with aspirin‐inducible asthma

“…Obviously, a double‐blind design was possible only for controls and patients with ATA. Patients with AIA received the saline challenge first and a single dose of L‐ASA corresponding to the last cumulative dose that caused a decrease in FEV 1 of 20% compared with baseline in the preliminary test (15). In controls and in patients with ATA a single 128 mg dose of L‐ASA was used for the L‐ASA inhalation challenge.…”

Nebulized Furosemide for the Management of Dyspnea: Does the Evidence Support Its Use?

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