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Cardiac side effects of long-acting beta-2 agonist salmeterol in asthmatic children
F S Tunaoğlu1, I Türktaş, R Olguntürk
1Department of Pediatric Cardiology and Pediatric Allergy, Gazi University, Faculty of Medicine, Ankara, Turkey. pedcar@behcet.tip.gazi.edu.tr
Insights
Salmeterol, a long-acting beta 2 agonist, showed no cardiac side effects in children with asthma. This study indicates salmeterol is a safe treatment option for childhood asthma management.
Area of Science:
- Pediatric Pulmonology
- Clinical Pharmacology
- Cardiology
Background:
- Salmeterol is a long-acting beta 2 selective adrenoreceptor agonist.
- Previous reports suggest potential cardiac side effects in adult asthmatics.
- The safety profile of salmeterol in pediatric asthma requires further investigation.
Purpose of the Study:
- To evaluate the cardiac side effects of salmeterol in children with moderate asthma.
- To assess the impact of salmeterol treatment on cardiac function and rhythm in pediatric patients.
Main Methods:
- Seventeen children (6-13 years) with moderate asthma received 200 micrograms of salmeterol twice daily for 3 weeks.
- Cardiac safety was assessed using 24-hour ambulatory electrocardiography and echocardiography at baseline, day 2, and day 21.
- Evaluated parameters included heart rate, blood pressure, serum potassium, arrhythmias, and echocardiographic measures.
Main Results:
- A statistically significant increase in minimum and mean heart rates was observed during salmeterol treatment, though all values remained within normal limits.
- No significant differences were found in blood pressure, serum K+, maximum heart rate, ectopic beats, ejection fraction, stroke volume, cardiac output, or corrected QT interval.
- No patient-reported tremors or palpitations occurred during the study.
Conclusions:
- Salmeterol treatment in children with moderate asthma did not result in detectable cardiac side effects.
- The findings suggest that salmeterol is a safe medication for managing childhood asthma.
- Further long-term studies may be beneficial to confirm the sustained safety profile.
Background:
Salmeterol is a new long-acting beta 2 selective adrenoreceptor agonist. There are some reports about the cardiac side-effects of salmeterol in asthmatic adults. The aim of this study was to determine the cardiac side effects of salmeterol in children.
Methods:
Seventeen children with moderate asthma (aged between 6 and 13 years, mean 8.76 years) received salmeterol with a spacer device (Volumatic 200 micrograms daily, b.i.d.) for 3 weeks. All the children were evaluated by 24 h ambulatory electrocardiography monitoring and echocardiography before, on the second and on the 21st day of treatment.
Results:
In minimum heart rate measurements, there were significant differences between the baseline (mean +/- SD 54.29 +/- 7.13), second (59.24 +/- 6.86) and 21st day (60.65 +/- 8.23) results. Also, the mean heart rate before the treatment (89.59 +/- 6.78) was significantly different from that on the second (94.76 +/- 6.51) and 21st day (92.65 +/- 8.90) of treatment. Although all the values were within normal limits and there were no significant differences between the control group's values, a trend of increase in mean and the minimum heart rates was seen. There were no significant differences in blood pressure, serum K+, maximum heart rate, supraventricular and ventricular ectopic beats, ejection fraction, stroke volume, cardiac output and corrected QT interval at any time. No complaints of tremors or palpitations were reported.
Conclusions:
As no cardiac side effects were detected, it could be concluded that salmeterol is quite a safe drug for use in childhood asthma treatment.