Best drugs for avoiding paradoxical bronchospasm during spirometry

Asthma could be diagnosed by its characteristic presentation. Spirometry can help the diagnosis by revealing post-bronchodilator response. Classically, salbutamol [albuterol] is used for evaluating post-bronchodilator response. This drug causes paradoxical bronchospasm in less than 10% of asthmatic patients. This study aimed to evaluate the frequency of paradoxical bronchospasm with salbutamol during spirometry and compare it with other drugs that did not reveal paradoxical bronchospasm such as levalbuterol and ipratropium. One hundred-Ninety two asthmatic subjects were entered in this clinical trial. All patients showed clinical manifestations of asthma and revealed obstructive pattern during spirometry. They were randomly assigned into three groups of drugs included: salbutamol, levalbuterol and ipratropium. Two puffs of these drugs were administered via a spacer and patients waited for fifteen minutes for the maximal effect to take place. Then spirometry was obtained again and postbronchodilator FEV1 and its alterations were compared among the three groups. The mean +/- SD age of patients was 49.40 +/- 17.4 years; the mean age, demographic data, clinical findings and spirometry results showed no significant difference among groups. FEV1 percent of predicted was 58.6 +/- 19.5 which proved that most subjects were suffering from severe asthma. Improvement of FEV1 by salbutamol [22.2 +/- 3%] and levalbuterol [16 +/- 18%] was significantly more compared with ipratropium [9.4 +/- 11%] [t=2.5, P=0.01 and t=2.2, P=0.01, respectively]. Paradoxical bronchospasm [more than 12% decrease in FEV1] was seen in two [3%], one [1.5%] and four [6%] subjects of salbutamol, ipratropium and levalbuterol groups, respectively. Regarding clinical improvement, levalbuterol resulted in the higher frequency of clinical improvement compared to salbutamol and ipratropium. With the dosage recommended for reversibility testing during spirometry, salbutamol showed comparable bronchodilator response and paradoxical bronchospasm frequency compared to levalbuterol and ipratropium

Antitussive effect of Portulaca oleracea L. in guinea pigs

Several therapeutic effects including diuretic, anti-pyretic and anti-scurvy have been reported for Portulaca oleracea. In previous studies the analgesic, anti-inflammatory, anti-hypertensive, anti-oxidant, muscle relaxant effects and neuropharmacological effects of the aqueous extract of Portulaca oleracea have been demonstrated on experimental animals. In the present study the antitussive effect of this plant was evaluated. The antitussive effects of aerosols of two different concentrations of boiled extract, codeine, and saline were tested by counting the number of coughs induced by citric acid aerosol 10 min following exposure of animals. The effective concentration of extract causing 50% reduction of cough number [EC50] was also determined. The results showed significant reduction [p<0.001] in cough numbers following the use of both concentrations of the boiled extract [10.7 0.16 and 6.7 0.33 for%2.5 and%5 extracts respectively] compared to saline [14.8 0.30]. In addition there was a significant difference [p<0.01] between the cough numbers of the 5% extract with that of codeine [10.2 0.38]. In this study, EC50 of the plant extract was 4.5%. These results showed that the antitussive effect of Portulaca oleracea L. was comparable to codeine