A comparison of terbutaline inhaled by Turbuhaler® and by a chlorofluorocarbon (CFC) inhaler in children with exercise‐induced asthma

Abstract

The present study compared the bronchodilating effect of inhalation from the Turbuhaler (0.5 mg terbutaline x 2) with the effect of inhalation from the chlorofluorocarbon (CFC) inhaler (0.25 mg terbutaline x 4) in children aged 9-17 years with reproducible, exercise-induced asthma (EIA). The treatments were given on two occasions, 5 min apart (terbutaline 0.5 mg + 0.5 mg). The study was performed as a double-blind, double-dummy, and placebo-controlled trial in 12 asthmatic children. The study was conducted on three separate days. The bronchoconstriction was induced by steady running on a treadmill. Forced expiratory volume in 1 s (FEV1.0), vital capacity (VC), and volume of trapped gas (VTG) were measured before and after the exercise test and after treatment. The study showed that the same amount of terbutaline inhaled from the Turbuhaler or from a CFC inhaler is equally effective for reversing EIA, and that the Turbuhaler is possibly more effective for treating spasm in small airways.

Systematic review of clinical effectiveness of pressurised metered dose inhalers versus other hand held inhaler devices for delivering beta 2 agonists bronchodilators in asthma

“…Eighty nine papers provided 84 trials (see www.ncchta.org/execsumm/summ526.htm for details) that were included in the review (with nine trials being duplicate publications of trials already included). 4 – 16 20 – 86 Four of the included trials 74 83 – 85 reported more than one trial in their paper or had additional independent trial arms that met our inclusion criteria and were therefore analysed as separate trials. We wrote to 78 authors of the 80 included trials for further information and received 34 replies.…”

“…20 – 22 63 – 72 Most trials were in patients with mild to moderate asthma, as defined by a baseline forced expiratory volume in one second >50% of predicted.…”

Review of therapeutically equivalent alternatives to short acting beta 2 adrenoceptor agonists delivered via chlorofluorocarbon-containing inhalers

“…As an example, one study claimed that the Turbohaler was an effective alternative to CFC-MDI for the delivery of an identical dosage of terbutaline 43. Twelve subjects completed the crossover trial.…”

Airway deposition and airway effects of antiasthma drugs delivered from metered-dose inhalers

“…If a study is performed at only one dose level for each of the devices, it is not possible to verify that the response is on the slope of the dose-response curve if no difference between the two ways of administering the drug is observed. Unfortunately, many of the studies presented in the literature [8,[72][73][74][75][76][77][78] have an inadequate design and are, thus, inconclusive. A well-designed comparative study should include at least two dose levels, for at least one of the devices, and it is necessary to show a difference in the response between the two dose levels to draw conclusions.…”

“…Terbutaline Turbuhaler® and pMDI were compared with respect to the bronchodilating effect after exerciseinduced bronchoconstriction [73]. A dose of 0.5 plus 0.5 mg was given to children after exercise, and it was found that the effects on reversing of the exercise-induced asthma were similar after Turbuhaler® and pMDI.…”