Cumulative dose-response study comparing terbutaline pressurized aerosol administered via a pearshaped spacer and terbutaline in a nebulized solution

Abstract

The bronchodilator effects of cumulative doses of terbutaline 0.125 mg, 0.125 mg and 0.250 mg administered as a pressurized aerosol via a pear shaped spacer were compared with those of terbutaline 1.25 mg, 1.25 mg and 2.50 mg administered as a nebulized solution via a PARI-inhaler Boy. FEV1.0 and flow-volume curves in 13 patients were measured. Initial placebo treatment of both groups resulted in a significant increase in FEV1.0, especially when it was given in nebulized form. The increase after active drug was significant after 15 min, with only minor changes during the rest of the trial. The log-dose/increase in FEV1.0 showed that equipotent doses of pressurized and nebulized terbutaline were in the ratio 1 to 4. Administration by nebulization offered no clear advantage over use of a pressurized aerosol with a pearshaped spacer.

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.…”

Effects of Divided Doses of a Bronchodilator Aerosol and the Intervening Time Interval on the Forced Expiration

“…In order to estimate the effect of a single inhaled dose of 250 ug terbutaline, a mathematical model was applied. From previous cumu lative dose-response studies with an inter vening time interval of at least 15 min be tween the inhaled doses of terbutaline we calculated the linear relationship between the logarithm of the fractional dose of the total dose of terbutaline given in that study and the corresponding fractional in crease in FEVi [Thiringer and Svedmyr, 1974;Weber et al, 1979;Birk Madsen et al, 1982;Hidinger et al, 1983;Munch et al, 1983]. The following relationship was obtained: log (% of max increase in FEV)) = 1.44 + 0.273 x log (% of max accumu lated dose).…”

Sympathomimetics in acute severe asthma: inhaled or parenteral, nebulizer or spacer?

“…As lung deposition fraction is of the same order of magrutude, equal doses should be tested. In patients with stable asthma, studies comparing different modes of delivery in terms or bronchodilatation have shown either the MDI and ncbulizer to be equipotent [36,49), the MDI plus spacer and nebulizer to be equall.y effective but both better than lhe MDI alone (54J, or the MDI plus spacer to be more effective than the nebulizer [55,56].…”