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Intravenous beta agonist in severe acute asthma
B Cheong1, S R Reynolds, G Rajan
1Department of Clinical Pharmacology, Llandough Hospital, Penarth, South Glamorgan.
BMJ (Clinical Research Ed.)
|August 13, 1988
Summary
Intravenous salbutamol significantly improved lung function in severe asthma patients more than inhaled treatments. However, this method may cause cardiovascular side effects, warranting careful consideration.
Area of Science:
- Pulmonology
- Critical Care Medicine
- Pharmacology
Background:
- Acute severe asthma requires prompt and effective bronchodilator therapy.
- The optimal route of salbutamol administration for severe asthma remains a subject of investigation.
Purpose of the Study:
- To compare the efficacy of intravenous versus nebulized salbutamol in treating acute severe asthma.
- To evaluate short-term responses to different salbutamol administration routes.
Main Methods:
- A randomized trial was conducted involving 71 patients with acute severe asthma.
- Patients received initial nebulized salbutamol and hydrocortisone, then were randomized to either continuous intravenous salbutamol infusion or additional nebulized salbutamol doses.
- Peak expiratory flow rate changes over 4 hours were the primary endpoint.
Main Results:
- Intravenous salbutamol resulted in a significantly greater improvement in peak expiratory flow rate (25.2%) compared to nebulized salbutamol (14.3%).
- Two patients in the intravenous group withdrew due to tachycardia, while three in the nebulized group withdrew due to non-response.
Conclusions:
- Continuous intravenous salbutamol infusion is more effective than nebulized administration for acute severe asthma.
- Potential cardiovascular adverse effects, such as tachycardia, necessitate caution with intravenous salbutamol.