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Observation of Reduction of Nocturnal Asthma by an Inhaled Anticholinergic Drug

There is now considerable evidence that nocturnal asthma represents an exaggeration of the normal diurnal variation in airway caliber. There is a degree of resting cholinergic tone present in human airways. Since asthmatic subjects show an exaggerated bronchoconstrictor response to cholinergic agonists, it is possible that increased cholinergic tone at night might contribute to nocturnal asthma . There may be several possible mechanisms for the increase in cholinergic effects at night. There may be an increase in

Details of Nocturnal Asthma by an Inhaled Anticholinergic Drug

With placebo, there was a difference between morning and evening PEF of 61.0±45.0 L/min (mean ±SEM; p<0.01; n = 18), or a fall in morning PEF of 17.3 ±2.0 percent (expressed as a percentage of evening PEF). The percentage fall in PEF after 200μg of oxitropium bromide was not significantly different from that after placebo (15.6±3.1 percent), but there was a significant reduction in the percentage of morning fell after 400μg (10.3 ± 3.3 percent;

Reduction of Nocturnal Asthma by an Inhaled Anticholinergic Drug

The mechanism of nocturnal asthma is still uncer-tain. In both normal and asthmatic subjects, anticholinergic drugs cause bronchodilatation, thus indicating a degree of resting cholinergic tone in human airways. There is some evidence that vagal tone may be greater in asthmatic subjects than in normal subjects, since the sinus arrhythmia gap, which reflects cardiac vagal tone, is more prolonged. There is no direct evidence for circadian variation in cholinergic regulation of airway tone, but several

Considerations of Passive Smoking on Lung Function and Airway Reactivity in Asthmatic Subjects

Involuntary smoking produces unpleasant symptoms in many individuals. These subjective complaints may be sufficient cause to regulate smoking in confined public places. However, it remains controversial whether acute passive smoking is associated with important pulmonary physiologic hazards. The present study was designed to investigate whether involuntary smoking presents an acute respiratory risk to asymptomatic asthmatic individuals. Our data demonstrate that one hour of passive cigarette smoke inhalation by young, clinically stable asthmatics produced no change

Outcomes of Passive Smoking on Lung Function and Airway Reactivity in Asthmatic Subjects

Results obtained in individual subjects are shown in Table 2. Mean data and statistical comparisons between groups of paired data are provided in Table 3. Symptoms and Signs Marked eye irritation was a universal finding. Most individuals opted to wear the protective goggles after spending several minutes in the chamber. Three subjects experienced mild, transient, self-limiting cough. Except for eye and nasopharyngeal irritation, the subjects were comfortable and spent the time in the chamber reading

Acute Effects of Passive Smoking on Lung Function and Airway Reactivity in Asthmatic Subjects

Nonsmokers are frequently exposed to tobacco smoke in indoor environments. The potential health risks of such involuntary, or passive, smoking is a topic of intense interest. Current evidence suggests that passive smoking acutely lowers the angina threshold and that chronic passive smoking may lead to small airways dysfunction or lung cancer. There is a paucity of data on whether asthmatics may be at special respiratory risk from passive smoking. Asthma is characterized by hyperreactivity of

Deliberations of Pulsus Paradoxus in Asthma

Although determination of pulsus paradoxus (change in systolic pressure greater than 10 mm Hg) in the clinical setting is most commonly done by means of a sphygmomanometer cuff and stethoscope, in our experience, as well as that of other investigators, this is an inaccurate and difficult measurement; yet in very few studies of pulsus paradoxus in man has the arterial blood pressure been measured directly. In this study, direct measurement of systolic and diastolic pressures

Outcomes of Pulsus Paradoxus in Asthma

A typical record of induced pulsus paradoxus during hyperinflation is shown in Figure 1. On inspiration, there is a fall in systolic blood pressure which reaches a minimum usually on the second heartbeat following the fall in Ppl. Diastolic blood pressure also falls but to a lesser extent, resulting in a fall in pulse pressure. There follows a gradual recovery of systolic and diastolic pressures to a maximum in middle to late expiration. Figure 2

Factors Influencing Pulsus Paradoxus in Asthma

Effeets of respiration on the circulation have been recognized for many years. Exaggerated falls in blood pressure in association with enhanced variations in intrathoracic pressure (pulsus paradoxus) were first reported by Gauchat and Katz in 1924. Since pulsus paradoxus in patients with bronchial asthma did not appear to indicate an abnormality of the circulation but was thought to reflect transmission of the negative intrathoracic pressure to the vascular tree, it was not considered to be

The Pathophysiology of Asthma: Mucus Plugging of the Airways

At autopsy, the lungs from patients that die because of asthma are hyperinflated and tend not to collapse after the thorax is opened because the segmental and subsegmental airways and the bronchioles are filled with inflammatory mucus plugs. These plugs contain mucous, serous and cellular elements. The eosinophilic leukocyte is the cell which tends to predominate in these plugs, but other inflammatory cells and a large number of epithelial cells can also be found. The submucosa shows evidence of