Bronchodilator, cardiovascular, and hypokalaemic effects of fenoterol, salbutamol, and terbutaline in asthma

Ck, Wong; Pavord, Ian D.; Williams, James D.; Britton, John; Tattersfield, Anne E.

doi:10.1016/0140-6736(90)93099-b

Cited by 254 publications

(105 citation statements)

References 24 publications

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“…In the control group of horses, the low cardiac output was compensated for by an increase in systemic arterial blood pressure, possibly caused by an increased systemic vascular resistance. We did not record any decrease in systemic arterial blood pressure in our experimental horses following salbutamol administration which was however observed in human patients in studies conducted by Wong et al (1990), Bennet et al (1994) and Insulander et al (2004). In a study on horses, Lee et al (1998) also recorded a short-term decrease in systemic arterial blood pressure following intravenous administration of clenbuterol which lasted on average for 5 min.…”

Section: Discussionmentioning

confidence: 75%

“…The chronotropic action of salbutamol is derived from direct stimulation of β 2 receptors in the heart and from the baroreceptor reflex that results from peripheral vasodilatation caused by the influence on β 2 vascular receptors (Insulander et al, 2004). Studies in human medicine (Wong et al, 1990;Bennet et al, 1994;Insulander et al, 2004) describe the action of inhalation or intravenous salbutamol administration similarly: heart rate increase, peripheral vasodilatation and a decrease in diastolic arterial blood pressure caused by the above mentioned mechanisms.…”

Section: Discussionmentioning

confidence: 99%

“…Salbutamol is a selective β 2 adrenergic agonist; its inhalant administration is used in human medicine in patients suffering from primary pulmonary hypertension (Spiekerkoetter et al, 2002) or asthma (Wong et al, 1990).…”

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confidence: 99%

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The effects of inhalation salbutamol administration on systemic and pulmonary hemodynamic, pulmonary mechanics and oxygen balance during general anaesthesia in the horse

Patschova¹,

Kabeš²,

Krisová³

2010

Vet. Med.

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ABSTRACT:This research aimed to determine the effect of aerosolized salbutamol administration on systemic and pulmonary hemodynamic, pulmonary mechanics and oxygen balance in healthy horses during general anaesthesia. Six healthy Thoroughbreds (body weight range 471-587 kg) underwent two general anaesthesias in dorsal recumbency with and without aerosolized salbutamol administration in randomized order with a one month washout period. The anaesthesia was induced by 1.1 mg/kg of xylazine, 0.02 mg/kg of diazepam and 2.2 mg/kg of ketamine, maintained with isoflurane in oxygen and air and horses were mechanically ventilated. Measurement of arterial and pulmonary arterial blood pressures, cardiac output and arterial and mixed venous blood gas analysis was carried out. Spirometry was performed using a Horse-lite. After achieving a steady state, baseline (T 0 ) values of cardiac output, systemic and pulmonary arterial blood pressures, heart rate, dynamic compliance, airway resistance and arterial and mixed venous blood gas values and pH were recorded in both groups. In the S-group (salbutamol), 2 µg/kg of aerosolized salbutamol were administered synchronously with inspirium into the tracheal tube. In both groups data were recorded at 15, 30, 45 and 60 min (T 15 , T 30 , T 45 , T 60 ) after the baseline. PaO 2 /FiO 2 ratio, oxygen consumption (VO 2 ), oxygen delivery (DO 2 ), pulmonary shunt values were calculated. Data were tested for normality and compared within each group: T 0 value with T 15 , T 30 , T 45 , T 60 values using Wilcoxon's test with Bonferoni correction (significance level 0.0125). For each time point, comparisons were made between the S-and C-groups (control) using Wilcoxon's test. In the S-group, there was a significant increase in values (mean ± SD) of cardiac output (l/min), T 0 (38 ± 7), a peak at T 15 (64 ± 25.5), significantly higher values persisted throughout the period of anaesthesia; heart rate (beats/min), T 0 (32 ± 2), T 15 (40 ± 6), T 30 (38 ± 5); DO 2 (l/min), T 0 (5.8 ± 0.8), a peak at T 15 (9.6 ± 3.2), significantly higher values persisted until the end of anaesthesia and VO 2 (l/min), T 0 (1.1 ± 0.5), T 30 (1.6 ± 0.7) and T 45 (1.8 ± 0.5). In the C-group, there was a significant decrease in values of PaO 2 /FiO 2 ratio from T 0 (176 ± 67) to a minimum at T 60 (114 ± 36) and in DO 2 from T 0 (6 ± 2.3) to a minimum at T 60 (4.3 ± 1.2). A comparison of the S-and C-groups did not reveal any difference in the baseline data. Subsequently, significantly higher values of cardiac output, heart rate, DO 2 , and the PaO 2 /FiO 2 ratio were found in the S-group compared to the C-group. Pulmonary arterial blood pressure was significantly lower in the S-group. Aerosolized salbutamol administration in healthy horses during general anaesthesia caused hemodynamic changes which resulted in an elevation of oxygen delivery. It can have a positive effect on arterial oxygenation, but the effect varies between individuals.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

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The effects of inhalation salbutamol administration on systemic and pulmonary hemodynamic, pulmonary mechanics and oxygen balance during general anaesthesia in the horse

Patschova¹,

Kabeš²,

Krisová³

2010

Vet. Med.

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“…A reserva cardiológica na faixa etária pediátrica é maior. A tolerância a aumentos na freqüência cardíaca, ainda que transitórios, é superior, e sua potencialidade arritmogênica é menor 13,[27][28][29] .…”

Section: Discussionunclassified

Intravenous terbutaline in children

Sl²,

Zambonato³

et al. 1998

J Pediatr (Rio J)

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Objective: The authors describe their experience with the use of intravenous ß2 adrenergic (IV terbutaline) in patients admitted to a PICU with severe lower airway obstruction.Patients and methods: A retrospective study of all admissions to a PICU was conducted in Santo Antonio Hospital in Porto Alegre City (Brazil) during the winter of 1995. The files of all the patients that were treated with intravenous ß2 adrenergic as a bronchodilator were selected. The analysis included length of use, initial doses, maximal doses, associated phenomena, arterial blood gases and plasma level of potassium.Results: During the three months of study 367 patients were admitted to the PICU and 38 (10.3%) used IV terbutaline. This group of patients had a mean age of 13.8 ± 12.2 months old and used IV terbutaline for a mean length of 7.24 ± 3.6 days. The initial rate of infusion was 0.55 ± 0.25 mcg/kg/min with a mean therapeutic dose of 2.45 ± 1.18 mcg/kg/min. Twelve patients (31.5%) had increase in their heart rate (over 180 bpm) that prevented increases in the infusion rate. However this was a temporary effect. The patients under 12 months of age started with low infusion rates (0.45 ± 0.22 mcg/kg/min), when compared to children over 1 year old (0.57 ± 0.3 mcg/kg/min), p < 0.01. No patient developed pathologic heart rate attributed to the drug. The serum levels of potassium decreased significantly (p < 0.01) only in the group of patients under 1 year (4.1 ± 0.7 to 3.47 ± 0.52 mEq/L), but this difference had no clinical relevance.Comments: In view of these results the authors showed that the infusion of IV terbutaline in children is safe and presents a low risk if the criteria of administration and monitoring are followed. In this manner, IV terbutaline is an excellent therapeutic option for children with severe lower airway obstruction and no response to the conventional treatment.J. pediatr. (Rio J.). 1998; 74(6): 441-446: asthma, bronchodilators, terbutaline, ß2 adenergics, aerosoltherapy. ResumoObjetivo: Os autores descrevem sua experiência com o uso de ß2 adrenérgico (Terbutalina), por via endovenosa, em pacientes internados em UTI pediátrica com quadro grave de obstrução de vias aéreas inferiores.Pacientes e métodos: Foi realizado um estudo retrospectivo das admissões realizadas na UTI do Hospital da Criança Santo Antônio (HCSA) de Porto Alegre (RS-Brasil) durante o inverno de 1995, sendo selecionados os prontuários dos pacientes que utilizaram ß2 adrenérgi-cos endovenoso, para tratamento de broncoespasmo. Foram analisados dados referentes a tempo de uso, dose inicial, dose máxima utilizada, fenômenos associados, gasometria arterial e níveis séricos de potássio.Resultados: Nos três meses de estudo, foram admitidos 367 pacientes na UTI pediátrica, sendo que 38 (10,3%) vieram a utilizar terbutalina por via endovenosa. Esse grupo tinha uma idade média de 13,8 ± 12,2 meses e utilizou a terbutalina endovenosa por um tempo médio de 7,24 ± 3,6 dias. A taxa inicial de infusão foi de 0,55 ± 0,25 mcg/kg/min, e a dose terapêutic...

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“…As drogas que pertencem a este grupo farmacológico (terbutalina, salbutamol, fenoterol) apresentam potência broncodilatadora e efeitos clíni-cos similares 9 . As doses recomendadas costumam variar conforme protocolos estabelecidos pelos próprios serviços de maneira individualizada.…”

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Controversies in the pharmacological management of acute asthma in children

et al. 2002

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Objective: to present a review of controversial issues related to the pharmacological management of the treatment of acute asthma in children.Sources: articles published in national and international scientific journals. Data were selected from Lilacs and Medline databases.Summary of the findings: the article was organized into topics, presenting aspects on which there is consensus regarding the pharmacological treatment of asthma in children. Issues related to the use of metered dose inhaler versus nebulizers, the role of ß2-adrenergic drugs administered intravenously as well as the role of methylxanthine and magnesium sulfate are approached critically. Conclusions:Inhaled ß2-agonist drugs combined with corticosteroids remain the treatment of choice for acute episodes of asthma in children. Either nebulizers or metered dose inhalers connected to spacers are efficient for the relief of acute symptoms. Patients who are refractory to conventional treatment and develop severe acute asthma should receive ß2-agonist drugs intravenously, provided they are properly monitored. Methylxanthine and magnesium sulfate should be considered a second choice for selected patients.J Pediatr (Rio J) 2002; 78 (Supl.2): S151-S160: acute asthma, beta-agonist, magnesium sulfate, aminophylline. ResumoObjetivo: apresentar uma revisão acerca de questões controversas, relativas ao manejo farmacológico utilizado nos pacientes pediátricos portadores de asma aguda. Fontes dos dados: foram utilizadas informações de artigos publicados em revistas científicas nacionais e internacionais, selecionadas das bases de dados Lilacs e Medline.Síntese dos dados: o artigo foi estruturado em tópicos, apresentando aspectos consensuais no tratamento farmacológico da asma infantil. Questões relacionadas à utilização de inaladores dosimetrados versus nebulizadores, o papel das drogas ß 2 -adrenérgicas utilizadas pela via endovenosa, bem como das metilxantinas e do sulfato de magnésio, são abordados de maneira crítica.Conclusões: os ß 2 -agonistas administrados pela via inalatória, associados aos coricosteróides, permanecem o tratamento de eleição para episódios agudos de asma na população pediátrica. Tanto os nebulizadores quanto os inaladores dosimetrados, acoplados a espaçadores, são efetivos para alívio dos sintomas agudos. Pacientes refratários ao tratamento convencional, que evoluem para quadros de asma aguda grave, devem ter considerada a utilização de drogas ß 2 -agonistas pela via endovenosa, desde que adequadamente monitorizados. Quanto às metilxantinas e ao sulfato de magnésio, devem ser considerados alternativas secundárias para pacientes selecionados.J Pediatr (Rio J) 2002; 78 (Supl.2): S151-S160: asma aguda, beta-agonistas, sulfato de magnésio, aminofilina.

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Bronchodilator, cardiovascular, and hypokalaemic effects of fenoterol, salbutamol, and terbutaline in asthma

Cited by 254 publications

References 24 publications

The effects of inhalation salbutamol administration on systemic and pulmonary hemodynamic, pulmonary mechanics and oxygen balance during general anaesthesia in the horse

The effects of inhalation salbutamol administration on systemic and pulmonary hemodynamic, pulmonary mechanics and oxygen balance during general anaesthesia in the horse

Intravenous terbutaline in children

Controversies in the pharmacological management of acute asthma in children

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