Nebulised sodium cromoglycate and verapamil in methacholine induced asthma

SUMMARY Fifteen children with asthma underwent challenges with methacholine on separate days after double blind administration by nebuliser of either verapamil (5 mg), cromoglycate (20 mg), or saline (placebo). The provocation doses that produced a 20 % fall in forced expiratory volume in one second (PD20) were analysed. There was variation in the protective effects of verapamil and cromoglycate among the patients. Although cromoglycate produced an increase in PD20 in 53 % of the children tested, the protection was not significant when compared with the placebo. Verapamil was partially protective, however, in 80 % of children and achieved signifi-cantly better results than the placebo. We suggest that this is likely to be due to a direct effect on bronchial smooth muscle. One of the characteristic features of asthma is an increased sensitivity of airways to physical, chemi-cal, and pharmacological stimuli, such as histamine, bradykinin, and acetylcholine or its synthetic ana-logue, methacholine. 2Sensitivity to methacholine has become a valuable, reproducible, and widel