Nebulized saline solution of dry powder formoterol is useful for acute bronchospasm

Dos nuevos beta agonistas de efecto prolongado son actualmente usados clínicamente: salmeterol y formoterol. El primero no ha demostado efectividad en los casos de asma aguda mientras que el segundo, formoterol, comparable en su período de latencia al albuterol, no ha sido empleado en el manejo de las crisis de asma. En este estudio utilizamos mediciones de flujo espiratorio pico antes y después de la administración de 12 microgramos de fumarato de formoterol (ForadilR) en polvo seco vía nebulización, inmediatamente después de su dilución en solución salina estéril, a treinta pacientes con crisis de asma y grados variables de obstrucción bronquial. Los resultados muestran mejoría significativa a los 5 y 30 minutos después de su administración, sugiriendo estabilidad de este producto así como un novedoso enfoque costo efectivo por su menor dosificación y posible impacto sobre la frecuencia de readmisiones debido a una broncodilatación prolongada

NSAID facial angioedema in a selected pediatric atopic population.

Epidemiological data for drug reactions in pediatric medical literature as well as in specialized periodicals are scarce. A relationship between nonsteroidal antiinflammatory drugs (NSAIDs), facial angioedema and atopic status has been described in adults. A 10-year retrospective random review of 1,007 charts of atopic children (60.9% male) attending an allergy clinic for management of asthma and/or rhinitis was carried out. Careful attention was given to the written history of NSAID facial angioedema reactions (41 out of 1007, 4.07%) and atopy was confirmed if the patient had a family history and at least one positive skin prick test (>3 mm wheal compared to glycerosaline control) to aeroallergens. Telephone recall was performed when available. Patients were classified into four age groups as follows: a) 0-5 years old; b) 6-10 years old; c) 11-15 years old; and d) 16-21 years old. NSAID facial angioedema rates were as follows: group a 10/493 (2.0%), group b 14/361 (3.8%), group c 10/121 (8.2%), and group d 7/32 (21.8%). Aspirin was the most commonly reported NSAID, and less common were pyrazolones and ibuprofen. Of the 41 patient with chart-reported reactions, 27 (66%) could be contacted by telephone. Of these, 17 patients confirmed the facial angioedema NSAID reaction occurring once or more due to inadvertent exposure. No reactions were reported in the remaining 10 patients since no other NSAID, except acetaminophen, had been used for fever or pain. In conclusion, our data show the age dependency of these reactions and its rather frequent occurrence in such selected pediatric atopic populations. Since NSAIDs are used more frequently in younger children, exposure would not be a plausible explanation for these observations.

A new triad: sensitivity to aspirin, allergic rhinitis, and severe allergic reaction to ingested aeroallergens.

Increasing attention has recently been paid to a group of patients who experience anaphylaxis after ingestion of foods prepared with mite-contaminated wheat flour. We present three cases of this syndrome, which occurs more often in young adults with allergic rhinitis and/or asthma. We have observed an increased frequency of sensitivity to aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), manifested as urticaria or angioedema, in patients with this condition.