cardiovascular-agents and Bronchial-Spasm

Topics: Anti-Bacterial Agents; Anti-Inflammatory Agents; Antineoplastic Agents; Bronchial Spasm; Cardiovascular Agents; Humans; Illicit Drugs; Lung Diseases; Pleural Effusion

Beta-Blockers are often withheld from patients with obstructive airways disease, especially those with reversible airways disease due to fear of inducing bronchospasm. We report our single center experience of cautiously treating such patients who have concomitant chronic heart failure (CHF).. The use of cardioselective beta-blockers under caution and specialist supervision may be tolerable in many CHF patients with obstructive airways disease, resulting in clinical improvement rather than detriment.. A retrospective case notes analysis was performed on CHF outpatients who had obstructive airways disease and been treated with beta-blockers.. A total of 43 patients were identified, with an average ejection fraction of 31.8%; 18 of these patients had fixed obstructive airways disease, 15 patients had reversible obstructive airways disease, 10 patients had a label of obstructive airways disease (but no supporting evidence for the diagnosis in the hospital notes). In all 3 groups, beta-blockers had been initiated and maintained without any respiratory event over a median continuous exposure time of 135 days. Limitation of the dose was documented in only 2 patients because of worsening shortness of breath. New York Heart Association (NYHA) class significantly improved for the group with the use of these agents (p = 0.003).. A cautious approach (under specialist supervision) to beta-blocker use in patients with heart failure and airways disease can result in successful treatment. The implications of withholding these agents may have more serious consequences than their administration.

Topics: Adrenergic beta-Antagonists; Aged; Bronchial Spasm; Bronchoconstriction; Cardiovascular Agents; Chronic Disease; Heart Failure; Humans; Lung Diseases, Obstructive; Middle Aged; Patient Selection; Practice Guidelines as Topic; Retrospective Studies; Risk Assessment; Treatment Outcome

A wide variety of drugs can cause bronchospasm, even in patients with no relevant history.

Topics: Allergens; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Bronchial Spasm; Cardiovascular Agents; Excipients; Humans; Steroids; Vaccines

The Swiss Drug Monitoring Center (SANZ) uses a systematic approach to the collection of spontaneously reported individual cases on suspected adverse drug reactions (ADRs). Spontaneous reporting schemes are designed to detect new, rare and unexpected ADRs and to act as an early warning system but there is a tendency to overreport severe reactions.. The aim of the study was to determine drug-induced episodes of bronchospasm, their seriousness and predisposing risk factors. An ADR is classified as serious if the reaction results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability or incapacity.. From 1986 to 1995 SANZ received 8,191 case reports of suspected ADRs. In 187 cases (2%) bronchospasm was reported. In 55% of these cases the reaction was regarded as serious. Analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs) were reported most frequently and were involved in 24% of the cases of which 64.5% were classified as serious. In three cases a lethal outcome was reported after intravenous administration of metamizol. Anti-infectious agents were implicated in 18% (52% serious), cardiovascular drugs in 11% (50% serious), drug formulation agents in 9% (41% serious), vaccines and immunoglobulins in 5.5% (50% serious), and plasma volume expanders in 5.5% (80% serious). Other drug groups were involved in 27% of the cases. About 50% of patients experiencing bronchospasm after NSAIDs, pharmaceutical formulation agents, vaccines and immunoglobulins had predisposing risk factors such as asthma, atopy or drug allergy. In other drug groups a predisposing factor was identified in 27% or less.. Drug-induced bronchospasm is frequently reported with NSAIDs, anti-infective agents, cardiovascular drugs and excipients with a high proportion of serious reactions.

Topics: Anti-Infective Agents; Anti-Inflammatory Agents, Non-Steroidal; Bronchial Spasm; Cardiovascular Agents; Humans; Registries; Risk Factors; Switzerland