Methacholine challenge testing: comparative pharmacology.

Article Details

Citation

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.

DrugBank Data that Cites this Article

Drugs
Drug Interactions
DrugsInteraction
Methacholine
Terbutaline
Terbutaline may decrease effectiveness of Methacholine as a diagnostic agent.
Methacholine
Bambuterol
Bambuterol may decrease effectiveness of Methacholine as a diagnostic agent.
Methacholine
Isoetharine
Isoetharine may decrease effectiveness of Methacholine as a diagnostic agent.
Methacholine
Norepinephrine
Norepinephrine may decrease effectiveness of Methacholine as a diagnostic agent.
Methacholine
Phenylpropanolamine
Phenylpropanolamine may decrease effectiveness of Methacholine as a diagnostic agent.