Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: Beta Adrenergics - Their Proper Role in the Treatment of Asthma

Category: Asthma and Allergy


Beta adrenergic medicines such as adrenalin, Ventolin, Proventil and Alupent are appropriate medicines to treat and control bronchial asthma. The National Institute of Health, in fact, recommends that beta adrenergics be used along with Intal and corticosteroid sprays as the first line medicine to control recurrent bronchial asthma. The ideal way to use beta adrenergics is by inhalation form whenever possible. This helps to minimize side effects such as nervousness, jitteryness and tremor. Properly used, beta adrenergics are safe and have a very high threshold of safety in the case of an overdose.

In recent articles across the country a specific betaadrenergic medicine, Fenoterol was named as a possible cause for the increasing death rate in asthma. Actually, Fenoterol is not even available in the United States and is a very potent, long-acting beta adrenergic medicine only available in Canada and Europe. In a large retrospective study done in Canada by the Bohringher Ingleheim Pharmaceutical company which makes the drug, it was noted that several deaths related to asthma were associated with over use of this very potent and potentially dangerous drug. It is important not to generalize a danger in the use of all beta adrenergics and try to link them with the increasing death rate for asthma.

In fact, most experts in asthma including Dr. Michael Sly, formerly of LSU, who is now at the National Children's Hospital in Washington, D.C., feel that childhood deaths from asthma could be prevented, possibly as much as 90%, by earlier use of beta adrenergic medicines. So beta adrenergics such as Ventolin, Proventil and Alupent are appropriate medicines to reverse bronchospasm and help to control asthma.

Because we know there are some side effects with any asthma medicine that is a bronchodilator, it is important to treat the other important factor in asthma which is inflammation. This is done by using inhaled corticosteroid sprays and/or inhaled Intal.

The National Institute of Health just last year came out with a statement that these anti-inflammatory medicines should actually be considered for first line or co-first line use in controlling asthma.

In summary, beta-adrenergics are appropriate to be used for asthma and actually help save asthmatics rather than cause death, as long as they are used properly. One benefit from the scare with Fenoterol may be that doctors across the world will begin to use more anti-inflammatory medicines along with beta adrenergics. This will better control asthma and avoid even the remote possibility of a child getting into a severe crisis which may lead to death. For specific help in regulating your child's asthma, be sure to talk with your pediatrician or allergist or pulmonologist and work out a plan which is best for your child. For further advice on this subject anyone can call or write the:


American Academy of Allergy
611 East Wells Street
Milwaukee, WI 53202-9939

or call: (414) 272-6071


Mother's of Asthmatics
3554 Chain Bridge Road Suite 220
Fairfax, VA 22030-2709

or call: (703) 385-4404


Asthma and Allergy Foundation of America (Lafayette chapter) P.O. Box 52763
Lafayette, LA 70563


or call: (318) 893-3722.


Also, asthma support groups are available through the Asthma and Allergy Foundation of America,(Lafayette Chapter) which meets monthly at Voohries Hall in Lafayette and information on those meetings can be obtained by calling:


Barbara Dugas at 337-232-6595

Sharon Champagne at 337-232-4357


My own asthma support group meets the third Wednesday of every month from 7 to 8 PM at my office. To be included on that mailing list and reminded of the monthly meeting, please call Sandy at (337) 948-9606. Anyone concerned about a child with asthma is welcome at our meetings.