Their conclusions were that inhaled glucocorticoids do not protect against the tolerance to the bronchial protective effects of concurrently administered, B 2-agonist agents. Kalra et al1 demonstrated these same effects, comparing groups with and without the addition of inhaled steroid agents. B 2-agonist agents.1 Table 1. Based on current information, long-acting B 2 agonists should be used ONLY in conjunction with antiinflammatory medication. Salmeterol is not to be used for treatment of acute symptoms or exacerbations.
Patient education regarding correct use of salmeterol is critical.
Due to the long duration of action of salmeterol, it has been postulated that administering the agent to asthmatics may have the effect of blunting the symptoms of nocturnal asthma. Several studies,8-10 incorporating small numbers of subjects, have been conducted in an attempt to confirm this hypothesis. A study by Selby et al8 looked at the question of using salmeterol in place of oral theophylline for nocturnal asthma. Only 15 of the 23 enrolled patients were able to successfully complete the study. The study showed that there are no major differences between inhaled salmeterol and sustained-release theophylline when measuring symptoms, side effects, pulmonary function tests, or subjective sleep quality.