RESUMO
A case of inadvertent 'total' non-compliance with a course of antituberculous drugs is described. Subsequently the value of routine urine testing for rifampicin in a chest clinic was assessed. The butanol extraction test was found to be a simple and rapid guide to the identification of defaulting patients.
Assuntos
Antituberculosos/uso terapêutico , Cooperação do Paciente , Adulto , Feminino , Humanos , Rifampina/urina , Tuberculose Pulmonar/tratamento farmacológicoAssuntos
Aspergilose/cirurgia , Hemoptise/cirurgia , Pneumopatias Fúngicas/cirurgia , Cuidados Paliativos , Espondilite Anquilosante/complicações , Adulto , Aspergilose/complicações , Aspergillus fumigatus , Hemoptise/etiologia , Humanos , Pneumopatias Fúngicas/complicações , Masculino , Pessoa de Meia-Idade , Risco , ToracoscopiaRESUMO
We examined the bronchodilator responses to inhalation of salbutamol (200 micrograms) and of ipratropium bromide (40 micrograms) in the morning and in the afternoon before and during a course of oral prednisolone (40 mg daily) in 15 patients with chronic, partly reversible airflow obstruction. Bronchodilatation was assessed by measuring serial peak expiratory flow rates (PEFR) for six hours after aerosol drug administration and calculating the area under the time-response curves. Eleven patients were found to be corticosteroid resistant in not attaining a baseline bronchodilatation of at least 25% during corticosteroid treatment. These patients also failed to show any enhancement of their bronchodilator responses to either salbutamol or ipratropium bromide during prednisolone administration. We therefore conclude that there is no rationale for giving or continuing corticosteroid treatment in known steroid-resistant patients in the hope of nevertheless potentiating their bronchodilator responses to salbutamol or ipratropium bromide.
