Inhaled salbutamol (albuterol) vs injected epinephrine in the treatment of acute asthma in children

Becker, Allan B.; Nelson, Nancy A.; Simons, F. Estelle R.

doi:10.1016/s0022-3476(83)80679-9

Cited by 105 publications

(9 citation statements)

References 15 publications

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“…Dos de los fármacos más usados son el salbutamol y el fenoterol. La ruta de administración que se prefiere para los beta-2 agonistas es la vía inhalatoria (5,17,26,27) ya que esta maximiza la cantidad de droga aplicada a la vía aérea y minimiza los efectos colaterales. Una forma de administración adecuada es por medio de un microdosificador inhalatorio (MDI) (8,28) que ha demostrado ser tan o más eficaz que el nebulizador (29) ya que con el MDI se obtiene igual efecto broncodilatador con una menor dosis (28).…”

Section: Discussionunclassified

Efecto broncodilatador de fenoterol y salbutamol asociados a un corticoide en niños con crisis de asma.

Huaman¹,

Velasco²,

Vargas³

et al. 2013

Rev Med Hered

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Objetivo: Evaluar los efectos clínicos y colaterales de Fenoterol 100 ug/inh en microdosificador inhalatorio (MDI) con aerocámara y salbutamol 100 ug/inh en MDI con aerocámara ambos asociados a dexametasona endovenosa (0.3 mg/kg) en bolo. Material y métodos: En un estudio prospectivo, randomizado, multicéntrico se incluyó 60 niños con crisis asmática leve-moderada (30 para cada grupo). Ambos grupos fueron comparables en la evaluación inicial. Resultados: Fenoterol – Dexametasona dio mayor reducción del puntaje clínico (p<0.05) que Salbutamol - Dexametasona al minuto 120 (-2.86 vs -1.25 respectivamente). Asimismo un mayor aumento del Pico Espiratorio Forzado (PEF) (p<0.05) al minuto 60 en comparación a Salbutamol – Dexametasona (135 vs 54 respectivamente). Tanto para frecuencia respiratoria como para presencia de tremor los 2 grupos fueron comparables en todos los momentos de la evaluación. No se encontró diferencia significativa entre ambos grupos en la cantidad de altas al final del estudio (4 horas). Conclusiones: Concluímos que las combinaciones Fenoterol – Dexametasona y Salbutamol –Dexametasona son igualmente efectivas en el manejo de crisis asmática leves a moderadas en niños.

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Section: Discussionunclassified

Efecto broncodilatador de fenoterol y salbutamol asociados a un corticoide en niños con crisis de asma.

Huaman¹,

Velasco²,

Vargas³

et al. 2013

Rev Med Hered

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“…It has been described with epinephrine (adrenaline) and aminophylline (Halmagyi & Cotes 1959), isoprenaline (isoproterenol) and orciprenaline (metaproterenol) [Chapman 1969], and with both intravenous (Ballester et al 1989) and inhaled salbutamol (Harris 1972;Choo-Kang et al 1974;Coupe 1987). Nebulised salbutamol produced highly significant clinical hypoxia in 2 of 20 children requiring emergency treatment for acute asthma attacks [alveolar oxygen pressure (pa02) fall > 10%] (Becker et al 1983) and in a further 9 of 18 children (Pa02 fall >5%) when used in conjunction with intravenous aminophylline (Tal et al 1984). The V /Q ratio is preserved in the acute asthmatic attack by vasoconstriction of arterioles associated with areas of underventilated lung.…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetics of Theophylline and its Metabolites During Acute Renal Failure

Leakey

Elias-Jones

Coates

et al. 1991

Clinical Pharmacokinetics

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After unsuccessful therapy with salbutamol syrup and inhaled terbutaline a 3-year-old boy with an acute exacerbation of asthma was treated with nebulised salbutamol (albuterol), intravenous aminophylline and hydrocortisone. His condition continued to deteriorate and he required artificial ventilation. Subsequently, he became anuric, with liver dysfunction, nonspecific encephalopathy and limb tremor. Peritoneal dialysis was started. Plasma theophylline concentrations were monitored and maintained in the therapeutic or subtherapeutic range. Despite this, he was hyper-reflexic with limb tremor. Excessively high plasma concentrations of the principal theophylline metabolite, 1,3-dimethyluric acid, were found [maximum 92 mg/L (470 mumol/L)], which cleared only with the return of normal renal function. Plasma concentration monitoring of drugs other than theophylline was not performed. After the patient recovered, a pharmacokinetic study demonstrated that normal methylxanthine metabolism was re-established. Pharmacokinetic analysis indicated that the undue accumulation of the metabolites was a result of an inability to clear these compounds. Thus, pharmacologically and toxicologically active metabolites of theophylline may accumulate in anuric patients on peritoneal dialysis, producing clinical symptoms of toxicity. However, in the present case the possible role of metabolites of other drugs cannot be definitely excluded.

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“…No significant differences were found in pulmonary function testing. They did, however, find an increase in adverse effects including nausea and vomiting, headache, tremor, and palpitations [60]. A 1984 study of 46 children comparing the same therapies found a statistically significant difference in the percentage change of peak expiratory flow rate (PEFR), favoring the SABA [61].…”

Section: Parenteral Beta-adrenergicsmentioning

confidence: 99%

“…Adverse side effects are common in the studies evaluating epinephrine [60,61,63]. A 1988 study of 95 patients who received epinephrine for ASA showed no clinically important arrhythmias in the over 40 age group and 2 episodes of accelerated idioventricular rhythm in the younger group.…”

Section: Parenteral Beta-adrenergicsmentioning

confidence: 99%

Controversies in the Care of the Acute Asthmatic in the Prehospital and Emergency Department Environments

Tennyson

2015

Curr Emerg Hosp Med Rep

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Asthma is an episodic disease of the airways characterized by inflammation and constriction of the bronchi. It has a significant societal impact with over 25 million persons affected in the United States alone and annually accounts for approximately 3300 deaths in the US. Standard therapy for acute severe asthma is effective for most patients, but controversies exist surrounding the care of the impending or actual respiratory failure patient. Non-invasive positive pressure ventilation has been effective in multiple case reports, but lacks large trial evidence to support its use. Intravenous ketamine similarly has supporting case reports, but an absence of rigorous evidence. Finally, parenteral beta-adrenergic medications have a long history of use, but have not been consistently shown to be superior to inhaled short-acting beta agonists. Further, they have been associated with higher rates of adverse effects.

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Inhaled salbutamol (albuterol) vs injected epinephrine in the treatment of acute asthma in children

Cited by 105 publications

References 15 publications

Efecto broncodilatador de fenoterol y salbutamol asociados a un corticoide en niños con crisis de asma.

Efecto broncodilatador de fenoterol y salbutamol asociados a un corticoide en niños con crisis de asma.

Pharmacokinetics of Theophylline and its Metabolites During Acute Renal Failure

Controversies in the Care of the Acute Asthmatic in the Prehospital and Emergency Department Environments

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