Aside from the more traditional methods of treating
bronchial asthma, it has been the purpose of this review to consider some of the ancillary modes of
therapy and to decide if they have a place in clinical practice. Regarding
antihistamines, there is little evidence to support their
therapeutic use in the management of
asthma, but there is strong evidence for their safety in the treatment of
allergic rhinitis or
urticaria in asthmatic patients.
Iodides have been used for years, but there is no good body of evidence to demonstrate their effectiveness. While they may be helpful in rare cases, one must be fully aware of their potential side effects and toxicity.
Mucolytic agents induce
bronchospasm and for the present should be contraindicated in
asthma management. Of all ancillary modes of
therapy, the
anticholinergic agents seem the most promising. This is based on the theory of
cholinergic mechanisms in
asthma production as well as some clinical trials supporting this efficacy. Many of the problems of inhaled
atropine have been eliminated with the development of atropinelike
anticholinergic agents such as
ipratropium bromide and oxytropium but unfortunately, none of these has been approved as yet for use in the United States.