(9R)-9-chloro-11-17-dihydroxy-17-(2-hydroxy-1-oxoethyl)-10-13-16-trimethyl-6-7-8-11-12-14-15-16-octahydrocyclopenta[a]phenanthren-3-one and Bronchial-Spasm

Short-acting beta2-agonists like salbutamol and terbutaline are used as rescue medications for acute bronchoconstriction and relief of symptoms due to their rapid onset of action. The aim of this study was to assess whether inhaled beclomethasone dipropionate (BDP)/formoterol fumarate (FF) combination in extrafine formulation is non-inferior to salbutamol in the speed of reverting methacholine-induced bronchoconstriction and symptoms.. Fifty-six asthmatic patients were examined in a multicentre, randomised, double blind, double dummy, active treatment and placebo controlled three period cross-over study. On three different days, a single dose of BDP/FF 100/6 μg in pressurised metered-dose inhaler (pMDI) extrafine formulation or salbutamol 200 μg pMDI or placebo was inhaled after FEV(1) had dropped by 30-45% with methacholine challenge.. The median time to recovery of FEV(1) to 85% of baseline was similar for BDP/FF and salbutamol (3.66 and 2.15 min, respectively), but significantly longer for placebo (21.1 min). The planned analysis on adjusted mean time to recovery showed that the difference from methacholine-induced bronchoconstriction between BDP/FF and salbutamol was 3.82 min (95% confidence interval: -0.85 to 8.5), therefore greater than 3 min supposed in the study design. The difference between BDP/FF and salbutamol was not clinically significant. The two active treatments were also comparable in terms of the relief of symptoms (as assessed by the Borg dyspnoea scale).. BDP/FF combination has a fast onset of action, similar to that of salbutamol, and may represent a good alternative as rescue medication in asthmatic patients.

Topics: Adult; Albuterol; Asthma; Beclomethasone; Bronchial Spasm; Cross-Over Studies; Double-Blind Method; Drug Therapy, Combination; Ethanolamines; Female; Forced Expiratory Volume; Formoterol Fumarate; Humans; Male; Methacholine Chloride; Middle Aged

The effect of four weeks of treatment with beclomethasone dipropionate (BDP, 500 micrograms twice daily) on the bronchial responsiveness to propranolol was examined in 16 patients with mild asthma in a placebo-controlled, double-blind crossover study. Propranolol was inhaled in doubling concentrations and the results were expressed as the cumulative dose producing a 20 percent fall in FEV1 (PC20). After four weeks of treatment with BDP, the mean FEV1 increased from 82.0 percent predicted to 88.1 percent predicted. The difference was significant (p less than 0.001). Treatment with BDP did not significantly change the responsiveness to propranolol, the geometric mean PC20 being 3.17 mg/ml before and 3.64 mg/ml after BDP treatment. The recovery of FEV1 was faster after 60 minutes of BDP treatment in comparison with placebo treatment (beyond 90 minutes). This study suggests that BDP treatment is unable to reduce bronchial responsiveness to propranolol but can accelerate the recovery of bronchoconstriction induced by propranolol in asthmatic patients.

Topics: Administration, Inhalation; Adult; Asthma; Beclomethasone; Bronchial Provocation Tests; Bronchial Spasm; Double-Blind Method; Female; Forced Expiratory Volume; Humans; Male; Propranolol; Random Allocation; Time Factors

We studied 17 asthmatic patients complaining of coughing attacks, with or without asthma, when inhaling beclomethasone dipropionate aerosol (Becotide). Specific airway resistance (SRaw) was measured immediately after a maximal inspiration (MI) and after Becotide inhalation. The effect of a second inhalation of Becotide was measured 10 min after inhalation of salbutamol. MI and Becotide induced large, but transient, SRaw increases in all patients; in addition, the latter induced coughing reactions. After salbutamol pretreatment, Becotide inhalation did not increase SRaw but coughing usually persisted. In 6 patients only, the increase in SRaw after Becotide was larger than that observed after MI. In those patients, placebo and Aldecine (similar to Becotide except for the metering valve) aerosols induced SRaw increases similar to that observed after Becotide. These data suggest that Becotide-induced bronchoconstriction is mainly related to the deep breath required for the inhalation. Non-specific irritation of the airways was probably responsible for the additional bronchoconstriction noticed in some patients.

Topics: Aerosols; Airway Resistance; Albuterol; Asthma; Beclomethasone; Bronchial Spasm; Cough; Humans; Premedication

Topics: Administration, Inhalation; Adult; Asthma; Beclomethasone; Bronchial Provocation Tests; Bronchial Spasm; Drug Interactions; Ethanol; Follow-Up Studies; Glucocorticoids; Humans; Male; Respiratory Function Tests; Risk Assessment; Severity of Illness Index

Topics: Administration, Inhalation; Adrenal Cortex Hormones; Adult; Aerosol Propellants; Androstadienes; Anti-Allergic Agents; Anti-Inflammatory Agents; Asthma; Beclomethasone; Bronchial Provocation Tests; Bronchial Spasm; Ethanol; Fluticasone; Humans; Inflammation; Male; Solvents; TRPV Cation Channels

The authors describe a case of paradoxical bronchospasm with laryngospasm and cutaneous rash occurring in an asthmatic woman after the use, via metered-dose inhaler, of different bronchodilators containing soy-derived excipients. It is noteworthy that the patient was not affected by soy allergy. After a short review of the relevant literature, the authors consider the possible aetiopathogenetic factors and outline the importance of this rare adverse reaction in the care of asthmatic patients.

Topics: Aerosols; Albuterol; Anti-Asthmatic Agents; Asthma; Beclomethasone; Bronchial Spasm; Bronchodilator Agents; Drug Eruptions; Excipients; Female; Fenoterol; Glycine max; Humans; Ipratropium; Laryngismus; Middle Aged; Nebulizers and Vaporizers

Topics: Adolescent; Albuterol; Allergens; Asthma; Beclomethasone; Bronchi; Bronchial Provocation Tests; Bronchial Spasm; Child; Child, Preschool; Cromolyn Sodium; Female; Humans; Hypersensitivity, Immediate; Immunoglobulin E; Male

Forty patients suffering from chronic bronchitis with basal forced expiratory volume in one second (FEV1) values at least 20% below ECSC (European Community Steel and Coal) predicted values were treated with a combination of salbutamol plus beclomethasone dipropionate or with theophylline for a period of 4 weeks. Methacholine bronchial inhalation challenges were performed before and after treatment. Both treatments produced significant increases in FEV1, forced vital capacity (FVC) and FEV1 100/FVC, while only the salbutamol plus beclomethasone dipropionate combination significantly reduced the decrease in FEV1 values after bronchial inhalation challenge.

Topics: Adult; Albuterol; Beclomethasone; Bronchial Provocation Tests; Bronchial Spasm; Bronchitis; Chronic Disease; Drug Therapy, Combination; Female; Forced Expiratory Volume; Humans; Male; Methacholine Compounds; Middle Aged; Theophylline

Topics: Adult; Atropine Derivatives; Beclomethasone; Bronchi; Bronchial Provocation Tests; Bronchial Spasm; Bronchitis; Chronic Disease; Ethanolamines; Fenoterol; Histamine; Histamine Antagonists; Humans; Ipratropium; Male; Middle Aged

Groups of guinea pigs sensitized with ovalbumin were treated with budesonide and beclomethasone dipropionate, respectively, in an intraperitoneal dose of 50 mg/kg. 20 h later, the anaphylactic release of histamine and slow reacting substance of anaphylaxis (SRS-A) from chopped lung tissue was studied. Whereas the corticosteroids studied had no effect on the tissue content of histamine or on the amount of antigen-induced release of this autacoid, budesonide and beclomethasone dipropionate to a great extent inhibited the release of SRS-A. The anti-anaphylactic effect of budesonide and beclomethasone was also shown in sensitized guinea pigs pretreated with mepyramine, 2.5 mg/kg intraperitoneally, and challenged with nebulized ovalbumin. We suggest that the partial protection given by the corticosteroids budesonide and beclomethasone dipropionate is due to the inhibiton of SRS-A release.

Topics: Anaphylaxis; Animals; Beclomethasone; Bronchial Spasm; Budesonide; Female; Glucocorticoids; Guinea Pigs; Histamine Release; Immunization; Male; Pregnenediones; Respiratory Tract Diseases; SRS-A

A 24-year-old asthmatic patient reported acute wheezing immediately after using an aerosol of beclomethasone dipropionate (Beclovent). She was hospitalised for bronchial challenges. Immediate bronchoconstriction was shown after two puffs of this aerosol and after inhalation of the placebo containing all the products of the aerosol less the beclomethasone. Another brand of beclomethasone aerosol, Vanceril, did not produce any reaction. Since the contents of these two beclomethasone aerosols are similar, the authors suggest that rubber or plastic derivative(s) present in the metering valve might have been responsible for the reaction.

Topics: Adult; Aerosols; Beclomethasone; Bronchial Provocation Tests; Bronchial Spasm; Female; Humans

Topics: Administration, Topical; Anaphylaxis; Animals; Beclomethasone; Betamethasone; Bronchial Spasm; Guinea Pigs; Injections, Intramuscular; Male; Rats; Respiratory System

Topics: Anaphylaxis; Beclomethasone; Bronchial Spasm; Chlorofluorocarbons, Methane; Drug Stability; Female; Humans; Middle Aged

Forty-two patients were treated with beclomethasone dipropionate in doses of 400 microgram daily for no longer than three months. There were three main indications : attempt to withdraw corticosteroids or sympathomimetics ; treatment prior to desensitization ; treatment of asthma with severe permanent dyspnea. In 8 patients, systemic steroids of sympathomimetic drugs could be withdrawn. Dosage could be reduced by 50% or more in 21 cases, and by less than 50% in 9 cases. There were 3 failures, and results were unassessable in one case. No major side-effects were observed.

Topics: Administration, Intranasal; Aerosols; Asthma; Beclomethasone; Bronchial Diseases; Bronchial Spasm; Humans; Lung Diseases, Obstructive; Time Factors

Topics: Adolescent; Adult; Aerosols; Aged; Airway Resistance; Asthma; Beclomethasone; Bronchi; Bronchial Spasm; Drug Tolerance; Female; Humans; Male; Middle Aged; Plethysmography; Time Factors

Topics: Adolescent; Adult; Aerosols; Beclomethasone; Bronchial Spasm; Dust; Female; Humans; Hypersensitivity, Delayed; Male

The current status of beta-adrenergics in the treatment of bronchospasm is discussed. Personal experience is reviewed with special attention being paid to associations of the drugs on aminophylline, atropine and bechlomethasone dipropionate.

Topics: Adrenergic beta-Agonists; Albuterol; Aminophylline; Atropine; Beclomethasone; Bronchial Spasm; Drug Synergism; Humans; Isoproterenol; Metaproterenol; Terbutaline