M. Crowell, E. Zayat, B. Lacy
Oct 1, 2001
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Influential Citations
111
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Quality indicators
Journal
Chest
Abstract
Study objectives Albuterol, aβ 2-adrenergic agonist that is commonly used to treat asthma, reduces bronchial smooth muscle tone. The pharmacodynamics of inhaled albuterol on esophageal function were studied in healthy volunteers. Design A prospective, randomized, placebo-controlled, double-blind crossover design. Setting An academic medical center. Patients Nine healthy volunteers (five men, four women; age, 22 to 30 years). Interventions Albuterol (2.5 to 10 mg) or placebo was given via nebulizer. Volunteers were studied at two sessions, 1 week apart, using a 6-cm manometry assembly and a low-compliance pneumohydraulic pump. The percentage of lower esophageal sphincter (LES) relaxation, the frequency of transient LES relaxations (TLESRs), and the amplitude, duration, and propagation velocity of esophageal contractions were measured at 5 and 10 cm above the LES. Dependent measures were evaluated using two-way, repeated-measures analysis of variance. Measurements and results Albuterol therapy reduced LES basal tone in a dose-dependent manner (baseline, 17.0 ± 2.6 mm Hg; at 10 mg, 8.9 ± 2.1 mm Hg; p=0.01). The frequency of TLESRs was not different from placebo (not significant). Albuterol reduced the amplitude of esophageal contractions at 5 cm above the LES (baseline, 72.5 ± 18.6 mm Hg; at 10 mg, 48.8 ± 10.0 mm Hg; p Conclusions Inhaled albuterol reduced LES basal tone and contractile amplitudes in the smooth muscle esophageal body in a dose-dependent manner. Inhaled β2-agonists may increase the likelihood of acid reflux in a subset of patients who receive cumulative dosing.