The bronchodilator response to inhalation of increasing doses of aerosolized albuterol

Nelson, Harold S.; Spector, Sheldon L.; Whitsett, Thomas L.; George, Ronald B.; Dwek, Joe H.

doi:10.1016/0091-6749(83)90502-x

Cited by 49 publications

(10 citation statements)

References 22 publications

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“…However concerns remain over side effects (Harvey et al, 1981) and the possible development of tolerance. The question of tolerance to P2-adrenoceptor agonists has been extensively studied with clear evidence of tolerance as regards heart rate (Barnes and Pride, 1983), metabolic responses (Harvey & Tattersfield, 1982;Jenne etal., 1977), tremor (Prior & Cochrane, 1982) and bronchodilator effects in normal subjects (Larsson et al, 1977), but the majority of studies have failed to detect evidence of bronchodilator tolerance in asthma (Larsson et al, 1977;Nelson et al, 1983;Tattersfield, 1985).…”

Section: Introductionmentioning

confidence: 99%

Regular nebulised terbutaline in chronic obstructive airways disease: dose‐response studies fail to detect tolerance.

Teale

Pearson

1991

Brit J Clinical Pharma

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Section: Introductionmentioning

confidence: 99%

Regular nebulised terbutaline in chronic obstructive airways disease: dose‐response studies fail to detect tolerance.

Teale

Pearson

1991

Brit J Clinical Pharma

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“…Adverse effects, especially tremor and palpitations, that arc caused by (T-reccptor agonists are fairly common, especially in the higher dose range [19], Although these side effects are seldomly relevant, they are quite disturb ing for the patient. Furthermore, the drug can induce hy pokalemia and stimulate tachyarrhythmias and angina pectoris in patients with preexisting coronary artery dis ease.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Bronchodilator Effects of Fenoterol/lpratropium Bromide and Salbutamol in Patients with Chronic Obstructive Lung Disease

Imhof

Elsässer²,

Karrer³

et al. 1993

Respiration

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A double-blind, randomized cross-over trial was carried out in 24 patients with chronic airflow obstruction. The patients were required to demonstrate a minimum 15% absolute increase in forced expiratory volume (FEV₁ after a standard dose (0.4 mg) of fenoterol (F). On a separate occasion the effect of ipratropium bromide (IB; 0.04 mg) on FEV₁ was tested also; according to the increase in FEV₁ the patients were grouped into IB responders (ΔFEV₁ 15%) and IB nonresponders (ΔFEV₁ < 15%). Two puffs of F/IB (0.1 mg/0.04 mg), salbutamol (S; 0.2 mg) and placebo (P) were given by metered-dose inhaler at the same time of the day on three different occasions. FEV₁ and specific airway resistance (sRaw) were assessed before and at specific intervals following inhalation. The results showed that F/IB and S produced similar maximal increases in FEV₁ (ΔFEV₁ 32% for F/IB and 31% for S) and decreases in sRaw (ΔsRaw 24% for F/IB and 21% for S). These effects were significantly different both from baseline values and from P. FEV₁ was still significantly different 8 h after inhalation from P in the F/IB group, but not in the group that received S. The effect of IB on FEV₁ in the pretest was compared with the subsequent response to F/IB. In IB responders F/IB seemed to produce slightly more effective bronchodilation. Side effects were minimal and clinically insignificant. In conclusion, F/IB, with its ability to effect sustained bronchodilation without adverse side effects, is a viable alternative to a monotherapy in chronic obstructive pulmonary disease.

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“…[49,62,66] Minor metabolic effects of salbutamol include slight increases in blood glucose, insulin, free fatty acids, lactate, pyruvate and ketones, and hypokalaemia, hypomagnesaemia, hypocalcaemia and hypophosphataemia. [49,66,72,76,77] Some nebulised salbutamol solutions contain an additive, benzalkonium chloride, which is associated with a 3% incidence of induced bronchoconstriction in patients with asthma (Hendeles L, personal communication).…”

Section: Clinical Pharmacologymentioning

confidence: 98%

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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The bronchodilator response to inhalation of increasing doses of aerosolized albuterol

Cited by 49 publications

References 22 publications

Regular nebulised terbutaline in chronic obstructive airways disease: dose‐response studies fail to detect tolerance.

Regular nebulised terbutaline in chronic obstructive airways disease: dose‐response studies fail to detect tolerance.

Comparison of Bronchodilator Effects of Fenoterol/lpratropium Bromide and Salbutamol in Patients with Chronic Obstructive Lung Disease

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

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