Skip to main content
SpringerLink
Log in

Clinical Pharmacology of Asthma

Implications for Treatment

  • Practical Therapeutics
  • Published:
Drugs Aims and scope Submit manuscript

Summary

The past 10 years have seen three important changes in the philosophy of managing asthma. First, histological studies using fibreoptic bronchoscopy have led to the recognition that asthma is an inflammatory condition of the bronchial mucosa and is not simply caused by smooth muscle spasm. Secondly, there has been some disenchantment with the long term use of regular β2-adrenergic agonists as these agents do not appear to control bronchial inflammation and have been associated with deaths from asthma. Thirdly, there has been a general shift away from physician-centred management towards patient-oriented management plans.

These three separate strands have led to the development of regional and international consensus documents that emphasise the use of regular anti-inflammatory treatment to control bronchial inflammation and reduce symptoms. With the emphasis on finding the minimum amount of treatment, several traditional anti-asthma medications have been downgraded in importance.

The introduction of self-management plans is to be welcomed, but it is important that these new strategies for treating asthma are properly evaluated so that the benefits they confer can be ascertained and maximised.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Aalbers R, Kauffman HF, Groen H, Koeter GH, de Monchy JGR. The effect of nedocromil sodium on the early and late reaction and allergen-induced bronchial hyperresponsiveness. Journal of Allergy and Clinical Immunology 87: 993–1001, 1991

    PubMed  CAS  Google Scholar 

  • Adinoff AD, Hollister JR. Steroid-induced fractures and bone loss in patients with asthma. New England Journal of Medicine 309: 265–268, 1983

    PubMed  CAS  Google Scholar 

  • Albazzaz MK, Patel KR. Effect of azelastine on bronchoconstriction induced by histamine and leukotriene C4 in patients with extrinsic asthma. Thorax 43: 306–311, 1988

    PubMed  CAS  Google Scholar 

  • Alexander A, Barnes N, Kay A. Trial of cyclosporin in corticosteroid-dependent chronic severe asthma. Lancet 339: 324–328, 1992

    PubMed  CAS  Google Scholar 

  • Altounyan RE. Review of clinical activity and mode of action of sodium cromoglycate. Clinical Allergy 10: 481–489, 1980

    Google Scholar 

  • Alvarez J, Surs W, Leung DY, Ikle D, Gelfand EW, et al. Steroid-resistant asthma: immunologic and pharmacologic features. Journal of Allergy and Clinical Immunology 89: 714–721, 1992

    PubMed  CAS  Google Scholar 

  • Andersson KE, Persson C. Extrapulmonary effects of theophylline. European Journal of Respiratory Disease 61: 17–28, 1980

    Google Scholar 

  • Antonissen LA, Mitchell RW, Kroeger Kepron K, Tse KS, et al. Mechanical alterations of the airway smooth muscle in a canine asthmatic model. Journal of Applied Physiology 49: 681–687, 1979

    Google Scholar 

  • Asmudsson T, Kisbirn KH, Lazlo J, Knock CJ. Immunosuppressive therapy of asthma. Journal of Allergy and Clinical Immunolology 47: 136–147, 1971

    Google Scholar 

  • Aubier M, De Sampson M, Macklem PT, Roussos C. Aminophylline improved diaphragmatic contractility. New England Journal of Medicine 305: 249–252, 1981

    PubMed  CAS  Google Scholar 

  • Balfour LL. Childhood asthma and puberty. Archives of Disease in Childhood 60: 231–235, 1985

    Google Scholar 

  • Beasley R, Roche W, Roberts JA, Holgate ST. Cellular events in the bronchi in mild asthma and after bronchial provocation. American Review of Respiratory Disease 139: 806–817, 1989

    PubMed  CAS  Google Scholar 

  • Bentley AM, Maestrelli P, Fabbri LM, Menz G, Storz C, et al. Activated T lymphocytes and eosinophils in the bronchial mucosa in isocyanate-induced asthma. Journal of Allergy and Clinical Immunology 89: 821–829, 1992a

    PubMed  CAS  Google Scholar 

  • Bentley AM, Menz G, Storz C, Robinson DS, Bradley B, et al. Identification of T lymphocytes, macrophages and activated eosinophils in the bronchial mucosa in intrinsic asthma. Relationship to symptoms and bronchial responsiveness. American Review of Respiratory Diseases 146: 500–506, 1992b

    CAS  Google Scholar 

  • Bone MF, Kubik MM, Keaney NP, Summers GD, Connolly CK, et al. Nedocromil sodium in adults with asthma dependent on inhaled corticosteroids in a double-blind, placebo-controlled study. Thorax 44: 654–659, 1989

    PubMed  CAS  Google Scholar 

  • Boner AL, Niero E, Antolini J, Vallette EA, Gaburro D. Pulmonary function and bronchial hyperreactivity in asthmatic children with house dust mite allergy during prolonged stay in the Italian Alps. Annals of Allergy 54: 42–45, 1985

    PubMed  CAS  Google Scholar 

  • Boner AL, Piacentini GL. Inhaled corticosteroids in children. Is there a safe dosage? Drug Safety 9: 9–20, 1993

    CAS  Google Scholar 

  • Booij-Noord H, Orie NGM, DeVries K. Immediate and late bronchial obstructive reactions to inhalation of house dust and protective effects of disodium cromoglycate and prednisolone. Journal of Allergy and Clinical Immunology 48: 344–354, 1971

    PubMed  CAS  Google Scholar 

  • Bordley JE, Carey RA, McGhee HA, Howard JE, Kattus AA, et al. Preliminary observations on effect of adrenocorticotrophic hormone (ACTH) in allergic diseases. Bulletin of the Johns Hopkins Hospital 85: 396–398, 1949

    PubMed  CAS  Google Scholar 

  • Bousquet J, Hejjaoui A, Michel FB. Specific immunotherapy in asthma. Journal of Allergy and Clinical Immunology 86: 292–305, 1990

    PubMed  CAS  Google Scholar 

  • Breslin FJ, McFadden EJ, Ingram RJ. The effects of cromolyn sodium on the airway response to hyperpnea and cold air in asthma. American Review of Respiratory Disease 122: 11–16, 1980

    PubMed  CAS  Google Scholar 

  • British Society for Allergy and Clinical Immunology. Injection immunotherapy. Clinical and Experimental Allergy 23 (Suppl. 4): in press, 1993

    Google Scholar 

  • British Thoracic Society, Research Unit of the Royal College of Physicians of London, King’s Fund Centre, National Asthma Campaign. Guidelines for the management of asthma in adults. I. Chronic persistent asthma. British Medical Journal 301: 651–653, 1990a

    Google Scholar 

  • British Thoracic Society, Research Unit of the Royal College of Physicians of London, King’s Fund Centre, National Asthma Campaign. Guidelines for the management of asthma in adults. II. Acute severe asthma. British Medical Journal 301: 797–800, 1990b

    Google Scholar 

  • British Thoracic Society, British Paediatric Association, Research Unit of the Royal College of Physicians of London, King’s Fund Centre, National Asthma Campaign, Royal College of General Practitioners, General Practitioners in Asthma Group, British Association of Accident and Emergency Medicine, British Paediatric Respiratory Group. Guidelines on the management of asthma. Thorax 48: S1–S24, 1993

    Google Scholar 

  • Britton J. Airway hyperresponsiveness and the clinical diagnosis of asthma: histamine or history? Journal of Allergy and Clinical Immunology 89: 19–22, 1992

    PubMed  CAS  Google Scholar 

  • Brogden RN, Sorkin EM. Nedocromil sodium. An updated review of its pharmacological properties and therapeutic efficacy in asthma. Drugs 45: 693–715, 1993

    CAS  Google Scholar 

  • Bruijnzeel PLB, Warringa RAJ, Kok PTM, Kreukniet J. Inhibition of neutrophil and eosinophil induced chemotaxis by nedocromil sodium. British Journal of Pharmacology 99: 798–802, 1990

    PubMed  CAS  Google Scholar 

  • Calverley PMA. The clinical efficacy of oxitropium bromide. Contemporary Pharmacotherapy 3: 189–196, 1992

    Google Scholar 

  • Clarke PS. The effect of beclomethasone diproprionate on bronchial hyperreactivity. Journal of Asthma 19: 91–93, 1982

    PubMed  CAS  Google Scholar 

  • Cockcroft DW, Murdock KY. Comparative effects of inhaled salbutamol, sodium cromoglycate, and beclomethasone dipropionate on allergen-induced early asthmatic responses and increased bronchial responsiveness to histamine. Journal of Allergy and Clinical Immunology 79: 734–740, 1987

    PubMed  CAS  Google Scholar 

  • Corrigan CJ, Brown P, Barnes NC, Szefler SJ, Tsai JJ, et al. Glucocorticoid resistance in chronic asthma. 1. Glucocorticoid pharmacokinetics, glucocorticoid receptor characteristics and inhibition of peripheral blood T-cell proliferation by glucocorticoids in vitro. American Review of Respiratory Disease 144:1026–1032, 1991a

    PubMed  CAS  Google Scholar 

  • Corrigan CJ, Brown P, Barnes NC, Tsai JJ, Frew AJ, et al. Glucocorticoid resistance in chronic asthma. 2. Peripheral blood T-lymphocyte activation and comparison of the T-lymphocyte inhibitory effects of glucocorticoids and cyclosporin A. American Review of Respiratory Disease 144: 1026–1032, 1991b

    PubMed  CAS  Google Scholar 

  • Crane J, Pearce N, Flatt A, Burgess C, Jackson R, et al. Prescribed fenoterol and death from asthma in New Zealand, 1981–83: casecontrolled study. Lancet 1: 917–922, 1989

    PubMed  CAS  Google Scholar 

  • Dannaeus A. Diet and asthma in infancy and childhood. European Journal of Respiratory Disease 65: 165–167, 1984

    Google Scholar 

  • De Vos C. New antihistamines. Clinical and Experimental Allergy 19: 503–507, 1989

    PubMed  Google Scholar 

  • Diaz P, Galleguillos FR, Gonzalez MC, Pantin CFA, Kay AB. Bronchoalveolar lavage in asthma: the effect of disodium cromoglycate on leukocyte counts, immunoglobulins and complement. Journal of Allergy and Clinical Immunology 74:41–48, 1984

    PubMed  CAS  Google Scholar 

  • Djukanovic R, Roche WR, Wilson JW, Beasley CRW, Twentyman OP, et al. Mucosal inflammation in asthma. State of the art. American Review of Respiratory Diseases 142: 434–457, 1990

    CAS  Google Scholar 

  • Djukanovic R, Wilson JW, Britten KM, Wilson SJ, Walls AF, et al. The effect of inhaled corticosteroids on airway inflammation and symptoms of asthma. American Review of Respiratory Disease 145: 669–674, 1992

    PubMed  CAS  Google Scholar 

  • du Toit JI, Salome CM, Woolcock AJ. Inhaled corticosteroids reduce the severity of bronchial hyperresponsiveness in asthma but oral theophylline does not. American Review of Respiratory Disease 136: 1174–1178, 1987

    Google Scholar 

  • Ehnert B, Lau-Schadendorf S, Weber A, Buettner P, Schou C, et al. Reducing domestic exposure to dust mite allergen reduces bronchial hyperreactivity in sensitive children with asthma. Journal of Allergy and Clinical Immunology 90: 135–138, 1992

    PubMed  CAS  Google Scholar 

  • Erzurum SC, Leff JC. Lack of benefit of methotrexate in severe steroid-dependent asthma. A double-blind, placebo-controlled study. Annals of Internal Medicine 114: 353–360, 1991

    PubMed  CAS  Google Scholar 

  • Frew AJ, Macfarlane JT. Are medical staff any better at using inhalers than patients? Thorax 37: 780, 1982

    Google Scholar 

  • Geddes DM. Methotrexate in asthma. Clinical and Experimental Allergy 21: 541–543, 1991

    PubMed  CAS  Google Scholar 

  • Graff-Lonnevig V. Childhood growth and inhaled steroids. Allergy 34: 57–61, 1979

    PubMed  CAS  Google Scholar 

  • Grainger J, Woodman K, Pearce N, Crane J, Burgess C, et al. Prescribed fenoterol and death from asthma in New Zealand, 1981–7: a further case-controlled study. Thorax 46: 105–111, 1991

    PubMed  CAS  Google Scholar 

  • Heard BE, Hossain S. Hyperplasia of bronchial muscle in asthma. Journal of Pathology 110: 319–331, 1971

    Google Scholar 

  • Helliwell M, Berry D. Theophylline poisoning in adults. British Medical Journal 2: 1114, 1979

    PubMed  CAS  Google Scholar 

  • Hodges NG, Brewis RAL, Howell JBL. An evaluation of azathioprine in severe chronic asthma. Thorax 26: 734–739, 1971

    PubMed  CAS  Google Scholar 

  • International consensus report on the diagnosis and management of asthma. Clinical and Experimental Allergy 22: S1–S72, 1992

    Google Scholar 

  • Jeffery PK, Godfrey RW, Adelroth E, Nelson FC, Rogers A, et al. Effect of treatment on airway inflammation and thickening of basement membrane reticular collagen in asthma. A quantitative light and electron microscopic study. American Review of Respiratory Disease 145: 890–899, 1992

    CAS  Google Scholar 

  • Jenkins CR, Woolcock AJ. Effect of prednisone and beclomethasone diproprionate on airway responsiveness in asthma: a comparative study. Thorax 43: 378–384, 1988

    PubMed  CAS  Google Scholar 

  • Kay AB. Asthma and inflammation. Journal of Allergy and Clinical Immunology 87: 893–910, 1991

    PubMed  CAS  Google Scholar 

  • Kerrebijn KF, van Essen-Zandvliet EEM, Neijens HJ. Effect of long term treatment with inhaled corticosteroids and beta-agonists on the bronchial responsiveness in children in asthma. Journal of Allergy and Clinical Immunology 79: 653–659, 1987

    PubMed  CAS  Google Scholar 

  • Kimata H, Yoshida A, Ishioka C, Mikawa H. Disodium cromoglycate selectively inhibits IgE production and enhances IgG4 production by human cells in vitro. Clinical and Experimental Immunology 84: 395–399, 1991

    PubMed  CAS  Google Scholar 

  • Koeter GH, Postma DS, Keyzer JJ, Meurs H. The effects of oral slow-release terbutaline on early morning dyspnoea. European Journal of Clinical Pharmacology 28: 159–162, 1985

    PubMed  CAS  Google Scholar 

  • Konig P. Inhaled corticosteroids — their present and future role in the management of asthma. Journal of Allergy and Clinical Immunology 82: 297–306, 1988

    PubMed  CAS  Google Scholar 

  • Kraan J, Koeter GH, van der Mark T, Sluiter HJ, de Vries K. Changes in bronchial hyperreactivity induced by 4 weeks of treatment with antiasthmatic drugs in patients with allergic asthma: a comparison between budesonide and terbutaline. Journal of Allergy and Clinical Immunology 76: 628–636, 1985

    PubMed  CAS  Google Scholar 

  • Laitinen LA, Laitinen A, Haahtela T. A comparative study of the effects of an inhaled corticosteroid, budesonide and a β2-agonist on airway inflammation in newly diagnosed asthma. A randomised double-blind parallel group study. Journal of Allergy and Clinical Immunology 90: 32–42, 1992

    CAS  Google Scholar 

  • Laitinen LA, Poppius H. Combination of oxitropium bromide and salbutamol in the treatment of asthma with pressurised aerosols. British Journal of Diseases of the Chest 80: 179–186, 1986

    PubMed  CAS  Google Scholar 

  • Leung KB, Flint Brostoff J, Hudspith BN, Johnson NM, et al. A comparison of nedocromil sodium and sodium cromoglycate on human lung mast cells obtained by bronchoalveolar lavage and by dispersion of lung fragments. European Journal of Respiratory Disease 147: 223–226, 1986

    CAS  Google Scholar 

  • Lichtenstein LM. An evaluation of the role of immunotherapy in asthma. Editorial. American Review of Respiratory Disease 117: 191–197, 1978

    CAS  Google Scholar 

  • Lipworth BJ. The β-agonist controversy: fact or fiction. Clinical and Experimental Allergy 22: 659–664, 1992

    PubMed  CAS  Google Scholar 

  • Littenberg B. Aminophylline treatment in severe acute asthma: a meta analysis. Journal of the American Medical Association 259: 1678–1684, 1988

    PubMed  CAS  Google Scholar 

  • Loftus BG, Price JF. Long term placebo controlled trial of ketotifen in the management of pre-school children with asthma. Journal of Allergy and Clinical Immunology 79: 350–355, 1987

    PubMed  CAS  Google Scholar 

  • PAF antagonist WEB 2086 on PAF-induced physiologic alterations and on IgE anaphylaxis in the rabbit. American Review of Respiratory Disease 142:390–397, 1990

    Google Scholar 

  • Lowhagen O, Rak I. Modification of bronchial hyperreactivity after treatment with sodium cromoglycate during the pollen season. Journal of Allergy and Clinical Immunology 75: 460–467, 1985

    PubMed  CAS  Google Scholar 

  • McWilliams Menendez R, Kelly HW, Howick J. Effects of theophylline on inhaled methacholine and histamine in asthmatic children. American Review of Respiratory Disease 130: 193–197, 1984

    PubMed  CAS  Google Scholar 

  • Medical Research Council. Double-blind trial comparing two dosage schedules of beclomethasone diproprionate aerosol with a placebo in chronic bronchial asthma. British Journal of the Diseases of the Chest 73: 121–132, 1979

    Google Scholar 

  • Moqbel R, Walsh GM, Wardlaw AJ, Kurlak L, Kay AB. Effects of nedocromil sodium on the activation of human eosinophils and neutrophils and the release of histamine from mast cells. Allergy 43: 268–276, 1988

    PubMed  CAS  Google Scholar 

  • Mullarkey MF, Blumenstein BA, Andrade WP, Bailey GA, Olason I, et al. Methotrexate in the treatment of corticosteroid-dependent asthma. A double-blind crossover study. New England Journal of Medicine 318: 603–607, 1988

    PubMed  CAS  Google Scholar 

  • Murphy S, Kelly HW. Cromolyn sodium: a review of mechanisms and clinical use in asthma. Drug Intelligence and Clinical Pharmacy 21: 22–35, 1987

    PubMed  CAS  Google Scholar 

  • Ohman JL. Allergen immunotherapy in asthma: evidence for efficacy. Journal of Allergy and Clinical Immunology 84: 133–139, 1989

    PubMed  Google Scholar 

  • Orange RP, Kaliner MA, Laraia PJ, Austen KF. Immunological release of histamine and slow reacting substance of anaphylaxis from human lung. II. Influence of cellular level of cyclic AMP Federation Proceedings 30: 1725–1729, 1971

    CAS  Google Scholar 

  • Patel KR, Kerr JW, Wade IM. The effect of disodium cromglycate on pulmonary function in extrinsic bronchial asthma over 12 months. Clinical Allergy 1: 199–207, 1971

    PubMed  CAS  Google Scholar 

  • Patel KR, Albazzaz MK. Protective effect of cromolyn sodium and nedocromil sodium in exercise-induced asthma. Journal of Allergy and Clinical Immunology 79: 187–190, 1987

    Google Scholar 

  • Pavia D, Bateman JR, Sheahan NF, Clarke SW. Effect of ipratropium bromide on mucociliary clearance and pulmonary function in reversible airways obstruction. Thorax 34: 501–507, 1979

    PubMed  CAS  Google Scholar 

  • Persson C. β2-agonists in asthma. Lancet 337: 301, 1991

    Google Scholar 

  • Petty TL, Rollins DR, Christopher K, Good K, Oakley R. Cromolyn sodium is effective in adult chronic asthmatics. American Review of Respiratory Disease 139: 694–701, 1989

    PubMed  CAS  Google Scholar 

  • Phillips MJ, Ollier S, Gould C, Davies RJ. Effect of antihistamines and antiallergic drugs on responses to allergen and histamine provocation tests in asthma. Thorax 39: 345–351, 1984

    PubMed  CAS  Google Scholar 

  • Platts-Mills TAE, Tovey ER, Mitchell EB, Moszoro H, Nock P, et al. Reduction of bronchial hyperreactivity during prolonged allergen avoidance. Lancet 2: 675–678, 1982

    PubMed  CAS  Google Scholar 

  • Rafferty P, Holgate ST. Histamine and its antagonists in asthma. Journal of Allergy and Clinical Immunology 84: 144–151, 1989

    PubMed  CAS  Google Scholar 

  • Rasmussen JB, Eriksson LO, Margolskee DJ, Tagari P, Williams VC, et al. Leukotriene D4 receptor blockade inhibits the immediate and late bronchoconstrictor responses to inhaled antigen in patients with asthma. Journal of Allergy and Clinical Immunology 90:193–201, 1992

    PubMed  CAS  Google Scholar 

  • Rebuck AS. Anti-asthmatic drugs II. Therapeutic aspects. Drugs 7: 370–390, 1974

    PubMed  CAS  Google Scholar 

  • Redier H, Chanez P, De Vos Rifai N, Clauzel AM, et al. Inhibitory effect of cetirizine on the bronchial eosinophil recruitment induced by allergen inhalation challenge in allergic patients with asthma. Journal of Allergy and Clinical Immunology 90: 215–224, 1992

    PubMed  CAS  Google Scholar 

  • Ruggieri F, Patalano F. Nedocromil sodium: a review of clinical studies. European Respiratory Journal 2 (Suppl. 6): 568–571, 1989

    Google Scholar 

  • Sears MR, Asher MI. Inhaler devices: how to use and which to choose. Current Therapeutics 26: 39–52, 1985

    Google Scholar 

  • Sears MR, Taylor DR, Print CG, Lake DC, Li QQ, et al. Regular inhaled beta-agonist treatment in bronchial asthma. Lancet 336: 1391–1396, 1990

    PubMed  CAS  Google Scholar 

  • Sears MR, Taylor DR, Print CG, Lake DC, Li QQ, et al. Regular inhaled beta-agonist treatment in bronchial asthma. Lancet 336: 1391–1396, 1990

    PubMed  CAS  Google Scholar 

  • Self TH, AbouShala N, Burns R, Stewart CF, Ellis RF, et al. Inhaled albuterol and oral prednisolone therapy in hospitalised adult asthmatics: does aminophylline add any benefit? Chest 98:1317–1321, 1990

    PubMed  CAS  Google Scholar 

  • Shiner RJ, Nunn AJ, Chung KF, Geddes DM. Randomised, doubleblind, placebo-controlled trial of methotrexate in steroid-dependent asthma. Lancet 336: 137–140, 1990

    PubMed  CAS  Google Scholar 

  • Simons FE, Soni NR, Watson WTA, Becker AB. Bronchodilator and bronchoprotective effects of salmeterol in young patients with asthma. Journal of Allergy and Clinical Immunology 90: 840–846, 1992

    PubMed  CAS  Google Scholar 

  • Smyllie HC, Connelly CK. Incidence of serious complications of corticosteroid therapy in respiratory disease. Thorax 23: 571–581, 1968

    PubMed  CAS  Google Scholar 

  • Spitzer WO, Suissa S, Ernst P, Horwitz RI, Habbick B, et al. The use of beta agonists and the risk of death and near death from asthma. New England Journal of Medicine 326: 501–506, 1992

    PubMed  CAS  Google Scholar 

  • Sporik R, Holgate ST, Platt-Mills TAE, Cogswell JJ. House dust mite antigen (Der PI) exposure and the development of sensitisation and asthma in childhood: a prospective study. New England Journal of Medicine 323: 502–507, 1990

    PubMed  CAS  Google Scholar 

  • Stafford W, Mansfield L, Yarbrough J. Cromolyn modifies histamine bronchial reactivity in symptomatic seasonal asthma. Annals of Allergy 52: 401–405, 1984

    PubMed  CAS  Google Scholar 

  • Stokes TC, Morley JF. Prospects for an oral Intal. British Journal of Diseases of the Chest 75: 1–14, 1981

    PubMed  CAS  Google Scholar 

  • Stolley PD, Schinnar R. Association between asthma mortality and isoproterenol aerosols — a review. Preventive Medicine 7: 519–538, 1978

    PubMed  CAS  Google Scholar 

  • Sugiyama H, Okada C, Bewtra A, Hopp RJ, Townley RG. The effect of formoterol on the late asthmatic phenomena in guinea pigs. Journal of Allergy and Clinical Immunology 90: 858–866, 1992

    Google Scholar 

  • Svendsen UG, Frolund L, Madsen F, Nielsen NH, Holstein RN, et al. A comparison of the effects of sodium cromoglycate and beclomethasone diproprionate on pulmonary function and bronchial hyperreactivity in subjects with asthma. Journal of Allergy and Clinical Immunology 80: 68–74, 1987

    PubMed  CAS  Google Scholar 

  • Szefler SJ, Brenner M, Jusko WJ, Spector SL, Flesher KA, et al. Dose and time-related effect of troleandomycin on methylprednisolone elimination. Clinical Pharmacology and Therapeutics 32: 166–171, 1982

    PubMed  CAS  Google Scholar 

  • Tattersfield A. Long-acting β2-agonists. Clinical and Experimental Allergy 22: 600–605, 1992

    PubMed  CAS  Google Scholar 

  • Thomson NC. Nedocromil sodium: an overview. Respiratory Medicine 13: 269–276, 1989

    Google Scholar 

  • Thoracic Society of Australia and New Zealand. Asthma management plan. Medical Journal of Australia 151: 650–653, 1989

    Google Scholar 

  • Toogood JH, Baskerville J, Jennings B, Lefcoe NM, Johansson SA. Use of spacers to facilitate inhaled corticosteroid treatment of asthma. American Review of Respiratory Disease 129: 723–729, 1984

    PubMed  CAS  Google Scholar 

  • Toogood JH, Jennings B, Greenway RW, Chuang L. Candidiasis and dysphonia complicating beclomethasone treatment of asthma. Journal of Allergy and Clinical Immunology 65: 145–153, 1980

    PubMed  CAS  Google Scholar 

  • Tschopp JM, Turner WM. Persisting airflow limitation in asthmatics receiving routine self-adjusted medication. European Journal of Respiratory Disease 65: 346–353, 1984

    CAS  Google Scholar 

  • Ullah MI, Newman GB, Saunders KB. Influence of age on response to ipratropium and salbutamol in asthma. Thorax 36: 523–529, 1981

    PubMed  CAS  Google Scholar 

  • Varney VA, Gaga M, Frew AJ, Aber VR, Kay AB, et al. Usefulness of immunotherapy in patients with severe summer hay fever uncontrolled by anti-allergic drugs. British Medical Journal 302:265–269, 1991

    PubMed  CAS  Google Scholar 

  • van Bever HP, Stevens WJ. Pharmacotherapy of childhood asthma. An inflammatory disease. Drugs 44: 36–46, 1992

    PubMed  Google Scholar 

  • Verleden GM, Belvisi MG, Stretton CD, Barnes PJ. Nedocromil sodium modulates non-adrenergic noncholinergic bronchoconstrictor nerves in guinea pig airways in vitro. American Review of Respiratory Disease 143: 114–118, 1991

    PubMed  CAS  Google Scholar 

  • Vincenc KS, Black JL, Yan K, Armour CL, Donnelly PD, et al. Comparison of in vivo and in vitro response to histamine in human airways. American Review of Respiratory Disease 128: 875–879, 1983

    PubMed  CAS  Google Scholar 

  • Wempe J, Postma D, Breederveld N, Alting-Hebing D, van der Mark T, et al. Separate and combined effects of corticosteroids and bronchodilators on airflow obstruction and airway hyperresponsiveness in asthma. Journal of Allergy and Clinical Immunology 89: 679–687, 1992

    PubMed  CAS  Google Scholar 

  • Wolthers OD, Pedersen S. Growth of asthmatic children during treatment with budesonide: a double blind trial. British Medical Journal 303: 163–165, 1991

    PubMed  CAS  Google Scholar 

  • Wolthers OD, Pedersen S. Short term growth during treatment with inhaled fluticasone and beclomethasone diproprionate. Archives of Disease in Childhood 68: 673–676, 1993

    PubMed  CAS  Google Scholar 

  • Wrenn K, Slovis CM, Murphy F, Greenberg RS. Aminophylline treatment for acute bronchospastic disease in the emergency room. Annals of Internal Medicine 115: 241–247, 1991

    PubMed  CAS  Google Scholar 

  • Zeiger RS, Schatz M, Sperling W, Simon RA, Stevenson DD. Efficacy of troleandomycin in outpatients with severe corticosteroiddependent asthma. Journal of Allergy and Clinical Immunology 66: 438–446, 1980

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Faculty of Medicine, University Medicine, Southampton General Hospital, University of Southampton, Level D, Centre Block, Tremona Road, Southampton, SO9 4XY, England

    Anthony J. Frew & Stephen T. Holgate

Authors
  1. Anthony J. Frew
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stephen T. Holgate
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Frew, A.J., Holgate, S.T. Clinical Pharmacology of Asthma. Drugs 46, 847–862 (1993). https://doi.org/10.2165/00003495-199346050-00005

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00003495-199346050-00005

Keywords

Search

Navigation