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Biomedical subjects

J Joad

Publications and source records attributed to J Joad.

4 recordsLinked to original sources

Beta-2 receptor agonists in asthma: a comparison.

Sympathomimetic bronchodilators with preferential specificity for the beta-2 receptor subtype are routinely used in asthma therapy. In addition to their ability to dilate bronchial smooth muscle following beta-2 receptor stimulation, these agents also inhibit mast cell mediator release and alter airway responsiveness. The importance of this class of drugs in asthma therapy has prompted the development of multiple asthma agents with the hope of achieving greater beta-2 receptor specificity, a quicker onset or more prolonged duration of action, a greater peak effect, or fewer side effects. This review compares the beta-2 agonists, as a group, with other asthma medications and, when data are available, makes comparison among various drugs within the group.

Adrenergic beta-Agonists↗

Histamine and airway caliber.

Since Dale and Laidlaw first produced airway obstruction in animals by infusing histamine, much has been done to understand the role of histamine in hyperreactive airway diseases. Histamine has been found to activate three subtypes of receptors: the H1 subtype, which mediates a number of cellular events resulting in airway obstruction; the H2 subtype, which plays an unclear and perhaps variable role in mediating airway caliber changes; and the newly described H3 subtype, which has not yet been studied in relation to airway caliber. The mechanisms involved in the synthesis, storage, and release of histamine from mast cells and basophils have been described. Pulmonary cells responsible for airway obstruction via H1 receptor stimulation have been identified and include bronchial smooth muscle, epithelial, endothelial, and pulmonary macrophage cells. Radioligand binding studies have begun to characterize the density and affinity of pulmonary H1 receptors. Intracellular events following H1 receptor stimulation have been shown to include calcium influx, phosphatidyl-inositol turnover, increases in cGMP, and the synthesis of prostaglandins. Despite a great deal of effort to define the relation between histamine and the parasympathetic nervous system, their exact interactions leading to changes in airway caliber remain to be resolved. Many pathologic conditions and mediators related to inflammation have been shown to increase histamine-induced airway responsiveness. A few endogenous mediators and a number of pharmacologic agents have been shown to decrease histamine-induced airway responsiveness. Although much has been done to elucidate the role of histamine and the H1 receptor system in modulating airway caliber, much more needs to be done to fully understand the complexities and significance of the H1 receptor system in normal and pathologic states of the airway.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

The effect of theophylline and beta 2 agonists on airway reactivity.

Increased airway responsiveness occurs in asthma, chronic bronchitis, cystic fibrosis, and other diseases. Theophylline and beta 2 agonists commonly are used as maintenance therapy for symptoms associated with the increased responsiveness. Both drugs can reduce airway responsiveness to a variety of provocational stimuli. With currently used dosing regimens, theophylline appears to produce relatively constant levels of effect on airway responsiveness and clinical efficacy around the clock, while inhaled beta 2 agonists appear to have insufficient effects at the end of longer dosing intervals. Improved dosing strategies for beta 2 agonists may improve the efficacy of these agents in the future.

Administration, Oral↗

Hyperkinetic/aggressive boys in treatment: predictors of clinical response to methylphenidate.

Data on 84 nonretarded boys aged 6--12 with the hyperkinetic/MBD syndrome were drawn from a comprehensive, longitudinal investigation in the interest of identifying factors that contribute significantly to variation in clinically rated improvement during treatment with methylphenidate. The size of the multiple correlation (R = .50) indicates that 25% of the variation in the children's response to methylphenidate is jointly predictable from age at referral, degree of perinatal complications, and score on the hyperactivity factor. The authors discuss stepwise multiple regression analysis as the method of choice in drug response prediction studies and the possible effects on the results of such studies of differing definitions of improvements.

Age Factors↗