Comparative efficacy of different methods of nebulising terbutaline

Abstract

The efficacy of terbutaline inhaled from different aerosol systems was studied in 13 adult asthmatics. Terbutaline 1 mg was delivered from a pressurised aerosol, 1 and 4 mg were inhaled from a nebuliser, 1 mg was inhaled through a pressurised aerosol with a pear-shaped, 750 ml spacer, and 1 mg was inhaled from a nebuliser with Intermittent Positive Pressure Ventilation (I.P.P.V.). An open, randomized, cross-over design was used. The bronchodilator effect was evaluated by recording hourly flow-volume curves and the FEV1.0 for 5 h after treatment. No significant difference in bronchodilatation was observed after inhalation of 1 mg terbutaline from different aerosol systems, except following use of the nebuliser, which required approximately four times as much terbutaline to obtain the same effect as the ordinary spray.

Comparison of the effectiveness of inhaler devices in asthma and chronic obstructive airways disease: a systematic review of the literature

“…A total of 16 papers were included for Review C, yielding 21 included studies due to Rochat and colleagues 1983a/b 250 being separate studies within the same paper and Cissik and colleagues 1986a/b/c, 136 Pedersen and Bundgaard 1983a/b, 251 and Zainudin and colleagues 1990a/b 244 describing multiple device/drug comparisons within a multiway crossover design.…”

Inhaler devices for the treatment of asthma and chronic obstructive airways disease (COPD)

“…[53][54][55] Twenty three studies in adults showed clinical equivalence for inhaler devices and nebulisers for the main pulmonary outcomes (FEV 1 and PEFR) and no evidence of significant difference in other outcomes. [56][57][58][59][60][61][62][63][64][65][66][67][68][69] Figure 5 shows the standardised mean difference of FEV 1 between nebulisers and hand held inhaler devices for the delivery of β agonists in stable asthma. 54 57-60 62 63 65-67 69-71 Updated searching identified two further studies.…”

Aerosol Therapy of Asthma: Principles and Applications

“…Equally reliable MDI delivery can be assured using one of the newer valved aerosol-holding chamber systems attached to the MDI [25,[32][33][34], With in creasing emphasis on cost control in North American hospitals, this approach to aerosol therapy is gaining increasing support as the cost is about 50% less than that for nebulizer-delivered bronchodila tor solutions [35] while at the same time aerosol-borne nosocomial infections are virtually eliminated with the use of the MDI [36].…”

“…There is now good evidence that aero sols delivered from MDIs are as effective as from other aerosol delivery systems [25,31], even in patients with life-threatening asthma, provided the 'usual' bronchodila tor dose is appropriately augmented (3-to 6-fold) [31]. Equally reliable MDI delivery can be assured using one of the newer valved aerosol-holding chamber systems attached to the MDI [25,[32][33][34], With in creasing emphasis on cost control in North American hospitals, this approach to aerosol therapy is gaining increasing support as the cost is about 50% less than that for nebulizer-delivered bronchodila tor solutions [35] while at the same time aerosol-borne nosocomial infections are virtually eliminated with the use of the MDI [36].…”