Methacholine challenge testing: comparative pharmacology.
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Davis BE, Blais CM, Cockcroft DW
Methacholine challenge testing: comparative pharmacology.
J Asthma Allergy. 2018 May 14;11:89-99. doi: 10.2147/JAA.S160607. eCollection 2018.
- PubMed ID
- 29785128 [ View in PubMed]
- Abstract
Standardization of the methacholine inhalation challenge, the most common direct bronchoprovocation test, is important. One aspect of standardization is the appropriate washout period for pharmacologic agents which affect the response. This review summarizes the available data on pharmacologic inhibition of the methacholine response. Specific (anti-muscarinic) agents demonstrate marked bronchoprotection (up to 7 days for the long-acting drugs) which lasts longer than the duration of bronchodilation. The functional antagonist (beta 2 agonist class of medications) shows marked, but less, bronchoprotection which is relatively short lived and is similar to the duration of bronchodilator efficacy. Tolerance develops quickly, especially to the long-acting agents. Single doses of controller medications, such as inhaled corticosteroids (ICS) and leukotriene receptor antagonists, have no effect on the methacholine test, while regular use, at least for ICS, has a modest protective effect whose duration is uncertain and likely variable. Theophylline has a small effect and H1 blockers (all generations) have a negligible effect.
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- Drug Interactions
Drugs Interaction Integrate drug-drug
interactions in your softwareMethacholineTerbutaline Terbutaline may decrease effectiveness of Methacholine as a diagnostic agent. MethacholineBambuterol Bambuterol may decrease effectiveness of Methacholine as a diagnostic agent. MethacholineIsoetharine Isoetharine may decrease effectiveness of Methacholine as a diagnostic agent. MethacholineNorepinephrine Norepinephrine may decrease effectiveness of Methacholine as a diagnostic agent. MethacholinePhenylpropanolamine Phenylpropanolamine may decrease effectiveness of Methacholine as a diagnostic agent.