D'Alonzo GE, Brown AC, Smolensky MH. Day-night variation of airways status in sympathomimetic- and theophylline-treated asthma patients. J Am Osteopath Assoc 1993;93(3):321. doi: https://doi.org/10.7556/jaoa.1918.104.22.1681.
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Eleven diurnally active asthma patients having a history of nocturnal asthma and treated regularly with albuterol or metaproterenol alone or with twice-daily sustained-release theophylline were evaluated for day-night pattern in peak expiratory flow (PEF) and use of supplemental j3-agonist aerosol for relief of acute asthma. Overall, significant daynight variation was observed in the supplemental use of j3-agonist medication and in airway patency. The patients managed by albuterol or metaproterenol alone used supplemental j3-agonist medication significantly more between 4 AM and 8 AM and also 8 PM and midnight in comparison to 4 PM to 8 PM; this was not true for those treated with both theophylline and j3-agonist aerosol. In patients taking a j3-agonist bronchodilator, the 24-hour mean PEF was greater than in those who also took theophylline, but the day-night variation in PEF was comparable. Supplemental isoproterenol use was significantly correlated with circadian amplitude of the PEF rhythm, but not with the 24-hour mean PEF. The greater the day-night variation in PEF, the greater the reliance on a supplemental j3-agonist bronchodilator.
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