Terbutaline metered-dose inhalation vs metaproterenol by hand-held nebulization: a comparison in black inner-city...

A greater percentage of the inner-city black population suffers from chronic obstructive pulmonary disease (COPD) than does the white population in general. Urban black patients are also more likely than urban white patients to receive primary care for their COPD symptoms in area emergency rooms, which can affect the resources available for medical care in these institutions. The present study compared the standard of therapy at Provident Medical Center, metaproterenol, administered by a hand-held nebulizer (HHN), with therapy using terbutaline, administered by a metered-dose inhaler (MDI) with a spacer, in 60 black patients with mild to moderate respiratory distress.Measurements of peak expiratory flow rates before and after therapy indicated that both methods of treatment provided similar relief. The terbutaline MDI modality, however, required less equipment and therapist time, and patients could continue the same therapy at home. All 60 patients were sent home on terbutaline MDI therapy. Follow-up by questionnaire, two to three weeks later, showed 95 percent of 36 respondents preferred the terbutaline MDI with spacer compared with their previous therapy.