Reversion of methacholine induced bronchoconstriction with inhaled diazepam in patients with asthma

Rev Med Chil. 2016 Apr;144(4):434-41. doi: 10.4067/S0034-98872016000400003.

Abstract

Background: Benzodiazepines have a direct bronchodilatory effect. Methacholine is a non-selective muscarinic receptor agonist causing bronchoconstriction.

Aim: To examine the effects of inhaled benzodiazepines, modulating bronchoconstriction induced by methacholine in patients with asthma.

Patients and methods: Twelve patients with well controlled asthma were studied. On the first day, after determining the initial values of pulmonary function, a dose response curve was carried out with progressive doses of methacholine. After the last dose, when at least a 20% drop of the initial forced expiratory volume in the first second (FEV1) was achieved, vital capacity (VC) and FEV1 were measured at 7, 15 and 30 minutes after provocation. On the second day a diazepam aerosol was inhaled by the patients prior to the same protocol with methacholine.

Results: In the first day of testing, methacholine inhalation (6 mg/mL) led to a significant drop in FEV1 from 2.98 to 1.69 L. On the second day of study, in the same patients, previous inhalation with diazepam reduced the changes of FEV1 after inhalation of methacholine. This parameter decreased from 2.48 to 2.21 L.

Conclusions: Inhalation of benzodiazepines reduce bronchoconstriction after a methacholine challenge in patients with asthma.

Publication types

  • Evaluation Study

MeSH terms

  • Administration, Inhalation
  • Adult
  • Anthropometry
  • Asthma / physiopathology
  • Asthma / prevention & control*
  • Benzodiazepines / therapeutic use
  • Bronchial Provocation Tests / methods
  • Bronchoconstriction / drug effects*
  • Bronchoconstrictor Agents / antagonists & inhibitors*
  • Diazepam / pharmacology*
  • Dose-Response Relationship, Drug
  • Female
  • Forced Expiratory Volume / drug effects
  • Forced Expiratory Volume / physiology
  • Humans
  • Male
  • Methacholine Chloride / antagonists & inhibitors*
  • Middle Aged
  • Receptors, GABA-A / therapeutic use*
  • Reference Values
  • Reproducibility of Results
  • Time Factors
  • Vital Capacity / physiology

Substances

  • Bronchoconstrictor Agents
  • Receptors, GABA-A
  • Methacholine Chloride
  • Benzodiazepines
  • Diazepam