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Communications to the Editor |

Tacholiquine Inhalation and Aspirin-Induced Asthma FREE TO VIEW

Miki Abo, MD; Masaki Fujimura, MD, FCCP
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Kanazawa University School of Medicine Kanazawa, Japan

Correspondence to: Masaki Fujimura, MD, FCCP, The Third Department of Internal Medicine, Kanazawa University, School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan



Chest. 2001;119(2):670. doi:10.1378/chest.119.2.670
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To the Editor:

Aspirin-induced asthma is exacerbated by some kinds of food and drug additives that are frequently included in the drugs used for the treatment of asthma, such as injected glucocorticosteroids.

Recently, we experienced a case of aspirin-induced asthma case with symptoms exacerbated by tacholiquine inhalation. A 69-year-old man visited our hospital for the treatment of asthma. He had experienced a severe asthma attack after an intake of diclofenac sodium. Aspirin-induced asthma was diagnosed using a sulpyrine inhalation test. The patient had been inhaling a mixed solution of salbutamol, tyloxapol, and tacholiquine regularly. One day in October 1997, when he inhaled a solution of tyloxapol and tacholiquine, coughs and wheeze occurred 30 min after the inhalation. Inhalation provocation with tacholiquine was performed after informed consent was obtained. An inhalation of 25% tacholiquine provoked a 20% decrease in FEV1 from the post saline solution inhalation value 30 min later (Fig 1). Tacholiquine inhalation did not cause bronchoconstriction in six other patients with moderate-to-severe asthma without aspirin sensitivity. Tacholiquine contains paraben as an additive, which might cause bronchoconstriction in this case.

Paraben has been used since the 1930s as a bacteriostatic agent added in many drugs, foods, and cosmetics.1It is well recognized that some patients with aspirin-induced asthma have hypersensitivity to paraben.2

Aerosolized tacholiquine is often used as a mucolytic agent for the treatment of chronic lung diseases, including asthma. Careful use is necessary in treating asthmatic patients because nearly 10% of patients with asthma have aspirin-induced asthma.

Figure Jump LinkFigure 1. Tacholiquine inhalation test results.Grahic Jump Location

References

Nagel, JE, Fuscaldo, JT, Fireman, P (1977) Paraben allergy.JAMA237,1594-1596. [CrossRef] [PubMed]
 
Juhlin, L, Michaëlsson, G, Zetterstrom, O Urticaria and asthma induced by food-and-drug additives in patients with aspirin hypersensitivity.J Allergy Clin Immunol1972;50,92-98. [CrossRef] [PubMed]
 

Figures

Figure Jump LinkFigure 1. Tacholiquine inhalation test results.Grahic Jump Location

Tables

References

Nagel, JE, Fuscaldo, JT, Fireman, P (1977) Paraben allergy.JAMA237,1594-1596. [CrossRef] [PubMed]
 
Juhlin, L, Michaëlsson, G, Zetterstrom, O Urticaria and asthma induced by food-and-drug additives in patients with aspirin hypersensitivity.J Allergy Clin Immunol1972;50,92-98. [CrossRef] [PubMed]
 
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