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Dose-related effects of nebulized metaproterenol in asthmatic children
E F Crain1, J C Gershel, A Kadar
1Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY.
Insights
A low dose of metaproterenol effectively treated acute bronchospasm in children. This 5 mg dose provided significant bronchodilation with fewer side effects than higher doses.
Area of Science:
- Pediatric Pulmonology
- Pharmacology
- Respiratory Medicine
Background:
- Acute bronchospasm is a common respiratory distress in asthmatic children.
- Metaproterenol is a bronchodilator used to treat asthma.
- Determining optimal dosage is crucial for efficacy and safety.
Purpose of the Study:
- To evaluate the dose-related effects of inhaled metaproterenol in children with acute bronchospasm.
- To identify the minimum effective dose of metaproterenol for bronchodilation.
- To assess the relationship between metaproterenol dosage and side effect incidence.
Main Methods:
- A double-blind, placebo-controlled study involving 60 asthmatic children aged 6-12 years.
- Random assignment to four groups receiving different doses of 5% metaproterenol (0, 0.1, 0.2, 0.3 ml).
- Spirometry (FEV1.0, FEF25-75, PEFR) was performed at baseline and at 15, 30, and 60 minutes post-inhalation.
Main Results:
- All treated groups showed significantly improved FEV1.0 and FEF25-75 compared to placebo.
- No significant differences in bronchodilation were observed between the different metaproterenol doses.
- A dose-dependent increase in side effects was noted with higher metaproterenol concentrations.
Conclusions:
- A 0.1 ml (5 mg) dose of nebulized metaproterenol appears to be effective for bronchodilation in pediatric acute bronchospasm.
- Lower doses of metaproterenol may achieve therapeutic benefits with a reduced risk of adverse effects.
- This suggests a potential for optimizing metaproterenol therapy in children by using the lowest effective dose.
Abstract:
The dose-related effects of inhaled 5% metaproterenol solution in asthmatic children between the ages of six and 12 years with acute bronchospasm were evaluated. Tests included FEV1.0, FEF25-75, and PEFR. For entry into the study, subjects were required to have an FEV1.0 or an FEF25-75 less than 80% of the child's predicted normal value based on height and race. Sixty children were randomly assigned in double-blind fashion to receive one of four different doses of 5% metaproterenol inhalant solution: 0.0 ml (placebo), 0.1 ml, 0.2 ml, or 0.3 ml. Drug efficacy was assessed by spirometry using a DeVilbiss Surveyor I spirometer. Spirometry was performed prior to inhalation of the test dose (baseline) and four times after inhalation: immediately after and 15, 30, and 60 minutes after inhalation. Patients in the three treated groups had significantly higher peak post-dose FEV1.0 and FEF25-75 than the placebo group but were not significantly different from one another. There was a significant relationship between dose and incidence of side effects. These results suggest that 0.1 ml (5 mg) of nebulized metaproterenol may provide as much bronchodilatation as higher doses with fewer side effects.