CHRONOPHARMACOLOGY OF ALBUTEROL IN HOSPITALIZED ASTHMATIC-CHILDREN

Eleven children (8-16 years old) hospitalized for acute bronchospasm w ere included in this investigation. Throughout the study, the children received the standardized course of therapy for hospitalized asthmati cs with corticosteroids and albuterol nebulizations. Children receivin g ipratropium were excluded from the study. Spirometric measurements, including forced expiratory volume in 1 s (FEV1), were made immediatel y before and 30 min after each albuterol nebulization over a 24-h peri od. The well-known temporal changes in FEV1 were observed in patients suffering from nocturnal asthma (NA): basal values were maximal at mid day (10 a.m. to 2 p.m.) and lowest in the evening or at night (10 p.m. to 6 a.m.). This 24-h variation in lung function was not found in chi ldren without nocturnal exacerbations of their asthma. A 24-h variatio n was also observed in albuterol-induced bronchodilation in patients w ith NA: maximal effectiveness occurred at night, and lower effect was obtained with the midday administration. The albuterol-induced increas es in FEV1 were not clinically significant in children without nocturn al asthma except when the beta2-agonist was inhaled between 10 p.m. an d 2 a.m. The data suggest that patients with nonnocturnal asthma might have different drug requirements than those with nocturnal symptoms.