ATS Pulmonary Function Laboratory Manual

chapter  14

Table 14.3

Medication Withholding Recommendations

Medication

Length of Abstention

Inhaled beta-agonists in conventional doses • Short-acting (e.g., albuterol)

6 hours 36 hours

• Long-acting (e.g., salmeterol) Inhaled anticholinergics • Short-acting (e.g., ipratropium) • Long-acting (e.g., tiotropium)

12 hours 48 hours

Antihistamines • Short-acting • Long-acting

48 hours

Assessment of Patients 1. The patient’s medical history should be reviewed by a trained physician or professional (5). This should include: 1.1. The current medications (e.g., bronchodilator and medications for control of blood pressure) 1.2. Tests including pulmonary function tests, blood gas data, chest radiograph, and blood chemistry results 1.3. Current symptoms, including chest pain, discomfort or wheezing, shortness of breath, and dyspnea on exertion 1.4. The patient’s exercise limitations and activities of daily living 1.5. The clinical diagnosis and reason for the test. 2. Assess each patient for physical and development status to determine ability to perform the diagnostic pro- cedure and if special arrangements are required. If there is a language barrier, an interpreter will be used. 3. Ask each patient if they have complied with the preparation procedures, including: 3.1. If they have eaten recently and, if so, when. 3.2. If they have taken any medications for their breathing. 3.3. If they have recently exercised, if so, when. 4. Postponement may be necessary if he/she have not complied with the preparation criteria. The ordering physician is to be contacted to determine if rescheduling is necessary. 5. In order to properly interpret the test results, relevant clinical information should be provided in writing by the ordering physician (i.e., diagnosis, and type of treatment) 3 days Note: Cromones, inhaled low-dose corticosteroids, and leukotriene modifiers have little or no effect in single dose and do not need to be withheld unless the intent is to offload an anti-inflammatory effect, in which case the withhold time should be weeks. Caffeine and caffeine-related products (e.g., chocolate) have no effect of clinical significance. Influenza vaccination, the menstrual cycle, and oral contraceptives do not significantly affect airway responsiveness.

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