To the Editor.—Drs. Chai and Newcomb have presented an excellent discussion of the pharmacological management of chronic asthma in childhood (125:757, 1973). Recent advertising for the newest pharmacological agent available for asthma, cromolyn sodium, emphasizes its supposedly unique role as a potential prophylactic drug for chronic asthma. I think that the most important contribution of Drs. Chai and Newcomb is their emphasis on using even the more traditional therapeutic drugs as prophylactic agents, aiming for sufficient continuous suppression of symptoms so that the patient can function acceptably. I submit this letter in an attempt to clarify recent work,1,2 to which Drs. Chai and Newcomb referred, that may allow bronchodilators to be used orally with both greater effectiveness and safety in the management of chronic asthma.
As the authors state, bronchodilators should form the backbone of office management of asthma. Such agents, however, have commonly been prescribed in fixed-dose combinations