Intranasal fenoterol in asthmatic subjects: an alternative route of administration

In a double-blind crossover trial the beta 2-agonist fenoterol was administered by the nose and by mouth in 10 patients with stable asthma. In both situations the bronchodilating effect of fenoterol as measured by changes in forced expiratory volume in 1 sec, peak expiratory flow, and maximal expiratory flow at 50% vital capacity was significant (p less than 0.01) compared to placebo. The fenoterol was given in the nose by means of two puffs of 0.2 mg in each nostril (total of 0.8 mg) from a pressurized canister while the patient was holding his breath at total lung capacity; it was followed by an exhalation through the nose. When an effect could be defined as a submaximal plateau, the medication was repeated once. The peroral administration consisted of an inhalation of 0.4 mg of fenoterol from the pressurized canister by use of a standard procedure. Also this medication was repeated after a submaximal effect could be defined. Neither after the first nor the second medication was there any significant difference between the effect on the lung function of the two ways of administration. It is concluded that the intranasal administration of fenoterol can be considered an alternative way of self-administration by the severely ill asthmatic subject who is unable to inhale the bronchodilator or can be used by the emergency staff on the first contact with the severely ill asthmatic patient in the hospital.