Inhaled Furosemide Is Not Effective in Acute Asthma

Karpel, Jill P.; Dworkin, Felicia; Hager, Dana; Feliciano, Sharon; Shapiro, Deborah R.; Posner, Laurie; Luks, Denise

doi:10.1378/chest.106.5.1396

Cited by 26 publications

(15 citation statements)

References 18 publications

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“…In contrast to our findings, other studies showed that inhaled furosemide was an ineffective treatment for asthma exacerbation when compared to inhaled furosemide (40 mg), inhaled metaproternol (15 mg) or both drugs combined 23. In addition, Van Bever et al 24 reported that aerosolised furosemide had no effect in infants with wheeze, while Raval et al 25 also found that furosemide inhalation had no effect on pulmonary function in infants with respiratory diseases.…”

Section: Discussioncontrasting

confidence: 99%

New complexes of inhaled furosemide and cyclodextrin: assessment of the bronchodilator effect

Al-Shdefat

2015

Eur J Hosp Pharm

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ObjectivesThe objective of this study was to investigate the efficacy in children of nebulised furosemide administered singly or in combination with β-cyclodextrins (β-CDs) on asthma exacerbations.MethodsA single-blinded randomised controlled study was conducted in five groups of children with moderate asthma. Twenty children were enrolled in each group: group 1 received nebulised salbutamol, group 2 received nebulised furosemide, group 3 received both salbutamol and furosemide, group 4 received a mixture of furosemide and β-CD in a 1:0.5 molar ratio, and group 5 received a mixture of furosemide and β-CD in a 1:1 molar ratio. Pulmonary function parameters, peak flow rates, respiratory rate, oxygen saturation and clinical scores were obtained before and after treatment.ResultsThe primary outcome of forced expiratory volume in 1 s (FEVl) improved after drug administration in all five groups of patients. The greatest FEVl% improvement was seen in group 3 children treated with the combination of furosemide and salbutamol (22.0±1.9; p<0.001). The greatest increases in forced vital capacity (FVC) were seen in group 3 (21.6±1.6; p<0.001) and group 4 (20.9±1.8; p<0.001).ConclusionsComplexes of furosemide and CDs led to a significant increase in peak flow rate and significantly improved FEV1, FVC, respiratory rate, arterial oxygen saturation (SaO2) and clinical scores as compared to other treatments. The complex effect was nearly equal to that of the furosemide and salbutamol combination. These results suggest that CDs are a promising approach for improving the efficacy of poorly water-soluble drugs administered by inhalation.

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Section: Discussioncontrasting

confidence: 99%

New complexes of inhaled furosemide and cyclodextrin: assessment of the bronchodilator effect

Al-Shdefat

2015

Eur J Hosp Pharm

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“…Within 20 minutes PaCO 2 fell from a mean of 57.7 to 40.6. However, Karpel and coworkers [224] could not demonstrate a statistically significant improvement in FEV 1 in 8 patients who received 40mg inhaled furosemide compared with 8 who received orciprenaline and 8 who received a combination of orciprenaline and furosemide.…”

Section: Furosemidementioning

confidence: 88%

Drug Therapy Approaches in the Treatment of Acute Severe Asthma in Hospitalised Children

2001

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Acute severe paediatric asthma remains a serious and debilitating disease throughout the world. The incidence and mortality from asthma continue to increase. Early, effective and aggressive outpatient therapy is essential in reducing symptoms and preventing life-threatening progression. When complications occur or when the disease progresses to incipient respiratory failure, these children need to be managed in a continuous care facility where aggressive and potentially dangerous interventions can be safely instituted to reverse persistent bronchospasm. The primary drugs for acute severe asthma include oxygen, corticosteroids, salbutamol (albuterol) and anticholinergics. Second-line drugs include heliox, magnesium sulfate, ketamine and inhalational anaesthetics. Future therapies may include furosemide, leukotriene modifiers, antihistamines and phosphodiesterase inhibitors. This review attempts to explore the multitude of medications available with emphasis on pharmacology and pathophysiology.

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“…Conventional treatments of asthma and COPD including β -agonists and corticosteroids are considered effective in the RAD symptom improvement. Besides, several studies have assessed the effect of nebulized furosemide in treating dyspnea which is the foremost symptom of RAD [12, 14, 15]. …”

Section: Discussionmentioning

confidence: 99%

“…These studies have suggested that nebulized furosemide, a loop diuretic, can exert a bronchodilatory effect [12] and has been used in combination with beta-agonists in the treatment of bronchial asthma and chronic obstructive pulmonary disease [13, 14]. Moreover, it could be effective in relieving dyspnea in cancer patients [15] and decreasing experimentally induced dyspnea in healthy subjects [16].…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Nebulized Furosemide and Salbutamol Compared with Salbutamol Alone in Reactive Airway Disease: A Double Blind Randomized, Clinical Trial

Masoumi

Forouzan

Shoushtari

et al. 2014

Emergency Medicine International

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We undertook this randomized clinical trial to investigate whether adding furosemide to salbutamol could improve the peak expiratory flow rate (PEFR) and clinical signs of reactive airway disease (RAD) patients. Eligible 18- to 55-year-old patients were randomly divided into intervention and control groups. Patients received 5 mg of nebulized salbutamol and 40 mg of nebulized furosemide in the intervention group and 5 mg of nebulized salbutamol alone in the control group. Patients in both groups received 100 mg of methylprednisolone intravenously stat. Severity of the RAD was estimated before and 45 minutes after treatment in both groups. PEFR was estimated before treatment and at 15, 30, and 45 minutes later. Ninety patients were enrolled, 45 in each group. There were no significant differences between two groups regarding gender, mean age, and normalized PEFR. The baseline mean PEFR was not significantly different between groups (P = 0.58). A repeated measure analysis of variance revealed that the differences between the two treatments was significant (P = 0.0001) and the behavior of two treatments was not similar across the time (P = 0.001). Comparison of clinical severity of acute RAD revealed no significant differences between groups at the end of the trial (0.06). This study showed that adding nebulized furosemide to salbutamol in RAD patients improved PEFR.

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Inhaled Furosemide Is Not Effective in Acute Asthma

Cited by 26 publications

References 18 publications

New complexes of inhaled furosemide and cyclodextrin: assessment of the bronchodilator effect

New complexes of inhaled furosemide and cyclodextrin: assessment of the bronchodilator effect

Drug Therapy Approaches in the Treatment of Acute Severe Asthma in Hospitalised Children

The Efficacy of Nebulized Furosemide and Salbutamol Compared with Salbutamol Alone in Reactive Airway Disease: A Double Blind Randomized, Clinical Trial

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