Terbutaline as powder inhalation from Bricanyl Turbuhaler compared to terbutaline as nebulizer solution in severe chronic airways obstruction

Twenty two adults with severe chronic airways obstruction--FEV1 from 14 to 57% of predicted--participated on two consecutive days in an open cross over comparison of inhalation of 2 mg terbutaline powder by Bricanyl Turbuhaler and 5 mg terbutaline by a conventional jet nebulizer (Pari Inhalierboy). All participants were domiciliary users of nebulized terbutaline previous to inclusion in this study. The mean (SD) maximal increase in FEV1 within the 60 minutes following inhalation by Turbuhaler and by Pari Inhalierboy was 27% (15%) and 28% (15%). The mean (SD) maximal increase in FVC was 30% (20%) and 29% (16%). The differences were not statistically significant. All participants were able to produce inspiratory flows high enough to use the Turbuhaler. The study suggests that it will be possible to replace the use of nebulizers with powder inhalations, as far as the bronchodilating effects are concerned.