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보존제 Benzalkonium 에 의한 역설적인 기관지 수축과 Cromolyn sodium 의 그 보호 효과
주현기(Hyun Ki Joo),최덕철(Duk Cheol Choi),윤운기(Woon Ki Yoon),오지섭(Ji Sub Oh),손기호(Kie Ho Son),차혜리(Hye Ri Cha) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 1995 소아알레르기 및 호흡기학회지 Vol.5 No.2
N/A Benzalkonium chloride has been used as a preservative in some antiasthmatic respirator solutions but is known to cause bronchoconstriction in asthmatic subjects. We studied the protective effect of cromolyn sodium on the bronchoconstriction of benzalkonium chloride by comparison of baseline pulmonary function (FEV1) with those after ventolin nebulization and mixed ventolin and clesin nebulization. Subjects were all from the Allergy Clinic of Wallace Memorial Baptist Hospital and free of respiratory disease and medication, 63 stable asthma patients. The results are as follows; 1) The falls in FEV1 were seen in 20 subjects (31.7%), over 10 (%predicted) falls in FEV1 in 7 subjects (11.1%) and over 20 (%predicted) falls in FEV1 in 4 subjects (6.3%) after ventolin nebulization. 2) Symptoms were provoked in 9 subjects (14.2%) as coughing. Mild dyspnea or chest tightness were seen in 2 subjects (3.1%) but these were solved within 20-30 minutes. 3) Protective effect with cromolyn sodium: increases in FEV1 (%predicted) were 7.7 after ventolin with clesin (0.4 cc) and 9.4 after ventolin with clesin (0.8 cc) nebulization than ventolin nebulization only. There was significant increase in FEV1 in ventolin with clesin than ventolin nebulization only. 4) Changes in protective effect depending on the doses of cromolyn sodi um: in all subjects, increases in FEV1 (%predicted) were 7.7 in clesin 0.4 cc group and 9.4 in clesin 0.8 cc group and in subjects with fall in FEV1, increases in FEV1 (%predicted) were 14.1 after ventolin with clesin (0.4 cc) and 17.5 after ventolin with clesin (0.8 cc) nebulization than ventolin nebulizationonly. There was no significant difference in FEV1 between clesin 0.4 cc and 0.8 cc groups. 5) Protective effect of cromolyn sodium on the degree of falls in FEV: increase in FEV1 (%predicted) after ventolin with clesin than ventolin nebulization in subjects with fall in FEV1 over 20 and others were 36, 6.6 in clesin 0.4 cc group and 36.5, 6.9 in clesin 0.8 cc group. There was significant increase in FEV1 in subjects with fall in FEV1 20 than others. So, we recommend that benzalkonium free salbutamol product should be used or cromolyn sodium should be added in ventolin respirator solution to protect the possibility of paradoxical bronchoconstriction by benzalkonium chloride and for the synergistic effect of salbutamol and cromolyn sodium
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