Effect of Terbutaline on Exercise Capacity and Pulmonary Function in Patients with Chronic Obstructive Pulmonary Disease

Abstract

The objective of this study was to investigate the effects of a single dose of a beta2-agonist, terbutaline (Bricanyl Turbuhaler), on resting lung function and exercise capacity in patients with chronic obstructive lung disease. Using a double-blind, placebo-controlled, randomized crossover study and outpatients from a department of pulmonary medicine at a major inner-city hospital, we examined 26 individuals with chronic obstructive lung disease who met the criteria of 40% </= FEV1 </= 70% of predicted, FEV1/FVC </= 70%, and DeltaFEV1 </= 200 ml 20 min after inhalation of 1 mg of terbutaline. The patients inhaled 2.5 mg of terbutaline and matched placebo. At rest, terbutaline caused significant increases in DLCO, MVV12sec, and all spirometric indices derived from the flow-volume loop, the increases also being significantly larger than those after inhalation of 1 mg of terbutaline for FEV1, FVC, and PEF. The peak work rate was unchanged after terbutaline. Oxygen uptake, ventilation, and tidal volume at peak work rate increased significantly, whereas carbon dioxide elimination increased insignificantly. Cumulative oxygen uptake and carbon dioxide elimination during progressive exercise to exhaustion and 10 min of recovery were significantly higher after terbutaline. We concluded that despite significant improvements in resting lung function, inhalation of 2.5 mg of terbutaline did not increase exercise capacity, but it increased cumulative oxygen uptake and carbon dioxide elimination during exercise and recovery, presumably because of a thermogenic effect of terbutaline.

Standardisation of the single-breath determination of carbon monoxide uptake in the lung

“…The mechanisms involved are not clear, although it is known that some fuel-cell CO analysers are sensitive to exhaled ethanol and ketones. In obstructive lung disease subjects, after administration of a bronchodilator, DL,CO may increase up to 6% [87]. Bronchodilators can affect VA, vasomotor tone, etc., and their use prior to testing could conceivably optimise these factors.…”

Regular inhaled short acting 2 agonists for the management of stable chronic obstructive pulmonary disease: Cochrane systematic review and meta-analysis

“…This observation confirms the bronchodilator effect of ISABA treatment in COPD observed in several acute studies. [19][20][21][22] None of the included studies was designed to investigate changes in bronchodilator activity over time, and our data show no evidence for the hypothesis that this activity is attenuated by chronic treatment with ISABA. The short duration of the included studies in this review made them unsuitable for evaluating any effect on disease progression over time.…”

Effect of salbutamol on the measurement of single‐breath diffusing capacity

“…Two studies demonstrated that 2.5 mg and 1.5 mg terbutaline significantly increased DL,CO in patients with chronic obstructive pulmonary disease and normal subjects. 3,4 However, other studies did not detect any difference in DL,CO after 200 mg salbutamol in obstructive patients 5 and 18 mg tiotropium in normal subjects. 6 Baldi et al 7 investigated the effect of incremental doses of salbutamol on DL,CO in patients with chronic obstructive pulmonary disease and found that DL,CO increased progressively with the dose, and the increase became significant at the highest dose of 1000 mg.…”

“…The published literature gives conflicting results. Two studies demonstrated that 2.5 mg and 1.5 mg terbutaline significantly increased D L ,CO in patients with chronic obstructive pulmonary disease and normal subjects . However, other studies did not detect any difference in D L ,CO after 200 μg salbutamol in obstructive patients and 18 μg tiotropium in normal subjects .…”