Asthma mannitol

Sonchus arvensis L. S. oleraceus L. Ju Shi Cai (Sow thistle) (whole plant) Inositol, lactucerol, mannitol, taraxasterol, palmitic acid, stearic acid, tartaric acid, lactucerols.50 Used as an insecticide, asthma, bronchitis, cough, ophthalmia, insomnia, pertussis, swellings and tumors. 

Brannan, J.D. Anderson, S.D. Koskela, H. Chew, N. Responsiveness to mannitol in asthmatic subjects with exercise- and hyperventilation-induced asthma. Am. J. Respir. Crit. Care Med. 1998,158. 

Orally administered corticosteroids are effective in the treatment of chronic bronchial asthma. The inhalation route has been widely used in attempts to avoid systemic side-effects, such as adrenal suppression, but evidence suggests that inhaled steroids are absorbed systemically to a significant extent. The respiratory tract epithelium has permeability characteristics similar to those of the classical biological membrane, so lipid-soluble compounds are absorbed more rapidly than lipid-insoluble molecules. Cortisone, hydrocortisone and dexamethasone are absorbed rapidly by a nonsaturable diffusion process from the lung, the half-time of absorption being of the order of 1-1.7 min. Quaternary ammonium compounds, hippurates and mannitol have absorption half-times, in contrast, of between 45 and 70 min. 

In 48 patients with asthma, aged 18-73 years, of whom 21 used inhaled corticosteroids and 23 had atopy, two pairs of bronchial challenges were performed with mannitol and methacholine in a random order on two separate days [62 ]. The airway response to mannitol was attenuated when mannitol was given after methacholine compared with the other way round, but the response to methacholine was not affected by order of administration. The authors concluded that bronchial challenge with inhaled mannitol and methacholine could be performed on the same day if the mannitol was given first. 

In addition to its use as an osmotic diuretic in cerebral oedema, mannitol is also frequently used in powdered form by inhalation to treat respiratory disorders like cystic fibrosis, asthma and bronchiectasis [SEDA-35,393],... 

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