Skip to main content
PMC home page
Thorax logoLink to Thorax
. 1986 Jun;41(6):468–472. doi: 10.1136/thx.41.6.468

Effect of nifedipine on arterial hypoxaemia occurring after methacholine challenge in asthma.

E Ballester, J Roca, R Rodriguez-Roisin, A Agusti-Vidal
PMCID: PMC460366  PMID: 3538481

Abstract

To investigate whether the effects of nifedipine on methacholine induced broncho-constriction could impair pulmonary gas exchange in bronchial asthma a randomised, double blind, crossover study in 13 symptom free asthmatic subjects was designed. Each patient underwent a methacholine bronchial challenge test on two separate days one week apart, after having either oral nifedipine (20 mg thrice daily) or placebo for three days. Arterial blood gases were measured before and after methacholine challenge in nine subjects. Prechallenge values of forced expiratory volume in one second (FEV1) and arterial oxygen tension (Pao2) were similar after nifedipine and after placebo. After challenge, the cumulative doses of methacholine required to produce a 20% fall in FEV1 (PD20 FEV1) were significantly larger after nifedipine (280 (SD 347)) cumulative breath units (CBU) than after placebo (120 (183) CBU; p less than 0.01). After challenge the fall in Pao2 values (17.1 (1.6) mm Hg; (2.28 (0.21) kPa)) was significantly greater than after placebo (11.7 (2.4) mm Hg; (1.56 (0.32) kPa) p less than 0.03). Our data show that although oral nifedipine significantly reduces airway reactivity in patients with mild bronchial asthma, it also adversely affects pulmonary gas exchange, resulting in a lowered postchallenge Pao2, probably because of worsening ventilation-perfusion relationships.

Full text

PDF
468

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alberts W. M., Ferguson P. R., Ramsdell J. W. Preparation and handling of methacholine chloride testing solutions. Effect of the hygroscopic properties of methacholine. Am Rev Respir Dis. 1983 Mar;127(3):350–351. doi: 10.1164/arrd.1983.127.3.350. [DOI] [PubMed] [Google Scholar]
  2. Bertel O., Conen D., Radü E. W., Müller J., Lang C., Dubach U. C. Nifedipine in hypertensive emergencies. Br Med J (Clin Res Ed) 1983 Jan 1;286(6358):19–21. doi: 10.1136/bmj.286.6358.19. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Braunwald E. Mechanism of action of calcium-channel-blocking agents. N Engl J Med. 1982 Dec 23;307(26):1618–1627. doi: 10.1056/NEJM198212233072605. [DOI] [PubMed] [Google Scholar]
  4. Cerrina J., Denjean A., Alexandre G., Lockhart A., Duroux P. Inhibition of exercise-induced asthma by a calcium antagonist, nifedipine. Am Rev Respir Dis. 1981 Feb;123(2):156–160. doi: 10.1164/arrd.1981.123.2.156. [DOI] [PubMed] [Google Scholar]
  5. Chatham M., Bleecker E. R., Norman P., Smith P. L., Mason P. A screening test for airways reactivity. An abbreviated methacholine inhalation challenge. Chest. 1982 Jul;82(1):15–18. doi: 10.1378/chest.82.1.15. [DOI] [PubMed] [Google Scholar]
  6. Corris P. A., Nariman S., Gibson G. J. Nifedipine in the prevention of asthma induced by exercise and histamine. Am Rev Respir Dis. 1983 Dec;128(6):991–992. doi: 10.1164/arrd.1983.128.6.991. [DOI] [PubMed] [Google Scholar]
  7. Fanta C. H., Drazen J. M. Calcium blockers and bronchoconstriction. Am Rev Respir Dis. 1983 Jun;127(6):673–674. doi: 10.1164/arrd.1983.127.6.673. [DOI] [PubMed] [Google Scholar]
  8. Fanta C. H., Venugopalan C. S., Lacouture P. G., Drazen J. M. Inhibition of bronchoconstriction in the guinea pig by a calcium channel blocker, nifedipine. Am Rev Respir Dis. 1982 Jan;125(1):61–66. doi: 10.1164/arrd.1982.125.1.61. [DOI] [PubMed] [Google Scholar]
  9. Gonzalez J. M., Morice R. C., Bloom K., Akers S., Raizner A. E., Stevens P. M. Inhibition of airway reactivity by nifedipine in patients with coronary artery disease. Am Rev Respir Dis. 1983 Feb;127(2):155–157. doi: 10.1164/arrd.1983.127.2.155. [DOI] [PubMed] [Google Scholar]
  10. Henderson A. F., Heaton R. W., Dunlop L. S., Costello J. F. Effects of nifedipine on antigen-induced bronchoconstriction. Am Rev Respir Dis. 1983 May;127(5):549–553. doi: 10.1164/arrd.1983.127.5.549. [DOI] [PubMed] [Google Scholar]
  11. Kennedy T. P., Michael J. R., Huang C. K., Kallman C. H., Zahka K., Schlott W., Summer W. Nifedipine inhibits hypoxic pulmonary vasoconstriction during rest and exercise in patients with chronic obstructive pulmonary disease. A controlled double-blind study. Am Rev Respir Dis. 1984 Apr;129(4):544–551. [PubMed] [Google Scholar]
  12. Kennedy T., Summer W. Inhibition of hypoxic pulmonary vasoconstriction by nifedipine. Am J Cardiol. 1982 Oct;50(4):864–868. doi: 10.1016/0002-9149(82)91246-2. [DOI] [PubMed] [Google Scholar]
  13. McFadden E. R., Jr Calcium-channel blocking agents and asthma. Ann Intern Med. 1981 Aug;95(2):232–233. doi: 10.7326/0003-4819-95-2-232. [DOI] [PubMed] [Google Scholar]
  14. Melot C., Hallemans R., Naeije R., Mols P., Lejeune P. Deleterious effect of nifedipine on pulmonary gas exchange in chronic obstructive pulmonary disease. Am Rev Respir Dis. 1984 Oct;130(4):612–616. doi: 10.1164/arrd.1984.130.4.612. [DOI] [PubMed] [Google Scholar]
  15. Naeije R., Mélot C., Mols P., Hallemans R. Effects of vasodilators on hypoxic pulmonary vasoconstriction in normal man. Chest. 1982 Oct;82(4):404–410. doi: 10.1378/chest.82.4.404. [DOI] [PubMed] [Google Scholar]
  16. Nair N., Townley R. G., Bewtra A., Nair C. K. Safety of nifedipine in subjects with bronchial asthma and COPD. Chest. 1984 Oct;86(4):515–518. doi: 10.1378/chest.86.4.515. [DOI] [PubMed] [Google Scholar]
  17. Pratter M. R., Woodman T. F., Irwin R. S., Johnson B. Stability of stored methacholine chloride solutions: clinically useful information. Am Rev Respir Dis. 1982 Oct;126(4):717–719. doi: 10.1164/arrd.1982.126.4.717. [DOI] [PubMed] [Google Scholar]
  18. Townley R. G. Calcium channel antagonists in coronary artery spasm and bronchial spasm. What do variant angina and bronchial asthma have in common? Chest. 1982 Oct;82(4):401–403. doi: 10.1378/chest.82.4.401. [DOI] [PubMed] [Google Scholar]
  19. Triggle D. J., Swamy V. C. Pharmacology of agents that affect calcium. Agonists and antagonists. Chest. 1980 Jul;78(1 Suppl):174–179. [PubMed] [Google Scholar]
  20. Wagner P. D., Dantzker D. R., Iacovoni V. E., Tomlin W. C., West J. B. Ventilation-perfusion inequality in asymptomatic asthma. Am Rev Respir Dis. 1978 Sep;118(3):511–524. doi: 10.1164/arrd.1978.118.3.511. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES