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- W2592901029 abstract "Asthma, a common condition, is defined by the American Thoracic Society and the National Asthma Education Program as a lung disease with (1) airway obstruction that is reversible, either spontaneously or with treatment; (2) airway inflammation; and (3) airway hyperresponsiveness (AHR) to various stimuli.1·2 In patients with asthma, several nonspecific agents or factors can produce bronchospasm. Measuring the response to standardized stimuli has become a method for quantitative assessment of the presence and degree of AHR. In allergic patients, specific allergens can provoke bronchoconstriction; however, they are rarely used for clinical testing because of lack of standardization and substantial risk. The most commonly used nonspecific agent is methacholine, a cholinergic agonist. Histamine, acetylcholine, adenosine, cold or dry air, and aerosols of distilled water or hypertonic saline can also be used. Measurement of airway responsiveness has been used in research studies, along with spirometry, to quantify the severity of asthma. It has also been used in clinical practice as a diagnostic procedure for patients in whom the presence of AHR helps confirm the presence of asthma or other disorders associated with AHR. Cigarette smokers have a greater degree of AHR than do nonsmokers, and smoking cessation often results in a decrease in the degree of AHR. The Lung Health Study found a surprisingly high rate of AHR in smokers with mild to moderate obstruction (85% in women and 59% in men).3 AHR can occur in other airway disorders, including cystic fibrosis, bronchiectasis, reactive airways dysfunction syndrome, and nonasthmatic atopy, and after exposure to various irritant gases. Procedure.—Methacholine challenge testing is performed by aerosolized administration of progressively increasing doses of the agent and by measurement of lung function at each step. The dose of the bronchoconstricting agent is increased until the FEV^ (forced expiratory volume in 1 second) decreases by a specified amount, usually 20%. Other measures of airway function, such as airway resistance or specific conductance, are sometimes used. The dose of methacholine, delivered by inhalation of a mist of methacholine solution, may be inhaled with full vital capacity inhalations or by continuous breathing of an aerosol for a fixed period. The dosimeter method uses an inspiration from a nebulizer that is triggered to deliver a short burst of methacholine aerosol during the middle of the inspiration. For clinical testing, full vital capacity breaths of continuous mist are commonly used." @default.
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- W2592901029 date "1994-01-01" @default.
- W2592901029 modified "2023-09-26" @default.
- W2592901029 title "Laboratory Medicine and Pathology Methacholine Inhalation Challenge" @default.
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