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Management of acute asthma in childhood. A randomized evaluation of beta-adrenergic agents
Insights
Inhaled beta-adrenergic agents are as effective as subcutaneous injections for treating acute childhood asthma. This study found similar treatment outcomes and fewer side effects with inhaled isoetharine compared to other methods.
Area of Science:
- Pediatric Pulmonology
- Pharmacology
- Emergency Medicine
Background:
- Acute asthma exacerbations are a common reason for pediatric emergency department visits.
- Beta-adrenergic agents are frequently used to manage asthma attacks.
- The optimal route of administration for these agents in children requires further investigation.
Purpose of the Study:
- To compare the efficacy of inhaled isoetharine hydrochloride versus subcutaneous epinephrine or terbutaline sulfate in treating acute asthma in children and adolescents.
- To evaluate the optimal route of administration for beta-adrenergic agents in pediatric acute asthma.
- To assess the incidence of adverse side effects associated with different administration routes.
Main Methods:
- A randomized study involving 269 pediatric patients (5-21 years) presenting with acute asthma.
- Patients received either inhaled isoetharine hydrochloride or subcutaneous epinephrine/terbutaline sulfate.
- Efficacy was assessed using clinical scores and pulmonary function tests; adverse effects were monitored.
Main Results:
- All treatment groups showed comparable success rates in resolving acute asthma attacks within 24 hours, whether through successful treatment, hospital admission, or further therapy.
- Adverse side effects were more frequently reported with terbutaline sulfate compared to epinephrine or isoetharine at the studied doses.
- Inhalation administration proved as effective as subcutaneous administration for beta-adrenergic agents in this pediatric population.
Conclusions:
- Inhaled beta-adrenergic agents are a viable and effective alternative to subcutaneous administration for treating acute asthma in children.
- Inhalation therapy may offer a favorable side effect profile compared to subcutaneous routes for certain agents.
- The route of administration does not significantly impact the short-term resolution of acute asthma attacks in pediatric patients.
Abstract:
We examined the efficacy of several beta-adrenergic agents commonly used to treat asthma and evaluated the optimum route of administration. Two hundred and sixty-nine persons aged 5 to 21 years who came to the emergency ward while suffering from acute asthma were treated with either (1) inhalation isoetharine hydrochloride or (2) subcutaneous epinephrine or terbutaline sulfate. Patients were evaluated using clinical scores and pulmonary function tests and were monitored for adverse side effects. Regardless of mode of therapy, the acute attack was either treated successfully, terminated in hospital admission, or required further therapy within 24 hours in a comparable number of patients. Adverse side effects were more common with terbutaline sulfate than with either epinephrine or isoetharine in the doses used. Thus, inhalation of beta-adrenergic agents is as effective as subcutaneous administration in the treatment of acute asthma in childhood.