How do I prepare for the test?

In order to optimize the best test results it will be necessary to withhold some medications prior to test day. We need your health to be stable, if you are running a fever over 100.7 or experiencing an upper respiratory infection please call our office to consult our nursing staff; as we may need to re-schedule the appointment.

  • 72 Hours Prior to Appointment: Stop all long-acting Antihistamines (Claritin, Loratadine, Clarinex, Zyrtec, Allegra, Zyzal, Astelin)
  • 48 Hours Prior to Appointment: Stop all long-acting Bronchodilators (Theophylline, Theodur, Serevent, Advair, Brovana, Symbicort, Foradil) and Anitcholinergics (Combivent, Atrovent, Spirvia, DuoNeb). Tilade or Intal.
  • 24 Hours Prior to Appointment: Stop all Leukotriene Modifiers (Singulair, Accolate, Zyflo)
  •  8 Hours Prior to Appointment: Stop all Oral and Inhaled Bronchodilators (ProAir, Volmax, Proventil Repetabs, Proventil MDI, Maxair, Ventolin or Albuterol MDI/solution, AccuNeb).

Why is this test being ordered?

Your doctor is concerned that some of your symptoms may indicate that you might have asthma or hyper-responsive airways. This test may help confirm or disprove that impression. This test is also occasionally done in a patient with known asthma in order to determine the degree of severity of the asthma.

What will the test tell the doctor?

This test will tell if your lungs are sensitive or reactive to Provocholine. Most patients with asthma are sensitive to Provocholine. If you have symptoms that suggest asthma, this test might help confirm or rule out this diagnosis.

How is the test done and how long will it take?

The test consists of a series of nebulized breathing treatments. During the nebulized treatment you will take 5 breaths (or 2 minutes continuous flow) of Provocholine mist. After each nebulized treatment you will rest for 3 minutes then blow into a machine called a spirometer that measures your lung function. During the test you will need to give your best effort with each blow into the spirometer. This will ensure that we get the best result possible. The test is stopped when pulmonary function tests indicate a 20% decrease in the airflow. This can occur at any dose of methacholine, if at all. If you don’t react to any dose the test takes approximately 3⁄4 of an hour.

What is Provocholine?

Provocholine is a chemical that stimulates certain nerves in the airways of the lungs that may cause the muscles in these airways to contract, causing narrowing in the airways. This narrowing is reflected in the pulmonary function tests performed after each dose. The Provocholine is gone from the system by 30 minutes after testing, if not sooner.

Are there any long term effects from Provocholine?

The test may make you wheeze or feel tightness in your chest, or feel short of breath. The nurse may give you a medication treatment, which will rapidly relieve the symptoms. There are no known long-term side effects.