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Speciality Spotlight
Asthma
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M Yung, M South (Royal Children’s Hosp, Melbourne, Victoria, Australia). Randomized Controlled Trial of Aminophylline for Severe Acute Asthma.
Arch Dis Child 79:405-410, 1998.
Aminophylline still has a role to play in the treatment of children with severe, acute asthma in whom initial treatment has been unsuccessful. However, agents with a lower risk of adverse effects, such as frequent ipratropium, should be used before aminophylline.
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Martin H Brutsche, I C Brutsche, et al
Comparison of pharmacokinetics and systemic effects of inhaled fluticasone propionate in patients with asthma and healthy volunteers: a randomized crossover study.
The Lancet, vol. 356, August 12, 2000, pg. 556-561.
In this study, pharmacokinetics of fluticasone propionate was studied in patients with asthma receiving appropriate doses for severity. It was a double-blind, randomised, cross-over study in 11 patients with asthma and 13 matched healthy controls. Patients received 1000 mciro-gm of Fluticasone propionate as a single IV dose or 1000 micro-gm per day for 7 days by inhalation (via spacer device). In the 12h, after dosing, plasma fluticasone propionate and cortisol concentrations were assayed.
Authors interpretation was that systemic availability of fluticasone propionate is substantially less in patients with moderate to severe asthma than in healthy controls. Inhaled corticosteroids that are absorbed through the lungs, need to be assessed in patients who are receiving doses appropriate for disease severity, and not in normal volunteers.
