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At least 19 recordsLinked to original sources

PubMed1977

Dose-response effects of albuterol aerosol compared with isoproterenol and placebo aerosols: response to albuterol, isoproterenol, and placebo aerosols.

Albuterol aerosol was an effective bronchodilator as reflected by indices of pulmonary function obtained from spirometry and flow volume curves; Compared with isoproterenol, there were minimal side effects even at the highest doses, and bronchodilation lasted significantly longer. In addition albuterol was successfully used by a patient with idiopathic hypertrophic subaortic stenosis who was unable to tolerate isoproterenol, as well as by some patients with idiosyncratic responses to isoproterenol; A few patients appeared to derive little benefit from either albuterol or isoproterenol.

Adolescent↗

PubMed1992

A comparison of salmeterol with albuterol in the treatment of mild-to-moderate asthma.

BACKGROUND: An effective, long-acting bronchodilator could benefit patients with asthma who have symptoms not controlled by antiinflammatory drugs. We compared a new long-acting, inhaled beta 2-adrenoceptor agonist, salmeterol, with a short-acting beta 2-agonist, albuterol, in the treatment of mild-to-moderate asthma. METHODS: We randomly assigned 234 patients (150 male and 84 female patients 12 to 73 years old) to one of three treatment groups: one group received 42 micrograms of salmeterol twice daily, one received 180 micrograms of albuterol four times daily, and one received placebo. Treatment was assigned in a double-blind fashion, and all patients could use supplemental inhaled albuterol as needed during the 12-week treatment period. RESULTS: Measurements of the forced expiratory volume in one second, performed hourly for 12 consecutive hours, showed that a single dose of salmeterol produced a greater mean area under the curve than two doses of albuterol taken 6 hours apart (6.3 vs. 4.9 liter.hr, P < 0.05). The difference was significant on day 1 and at week 4 of the study, but not at week 8 or 12. Salmeterol was also more effective than albuterol or placebo (with albuterol taken as needed) in increasing the morning peak expiratory flow rate: salmeterol induced a mean increase of 24 liters per minute over the pretreatment values, as compared with a decrease of 6 liters per minute with albuterol (P < 0.001) and an increase of 1 liter per minute with placebo (P = 0.002). The mean overall symptom score was improved most by salmeterol treatment (P < 0.05), with the number of days with symptoms and of nights with awakenings decreasing by 22 percent and 52 percent, respectively; there were no differences in results between albuterol treatment and placebo administration. We found no evidence of tolerance to the bronchodilating effects of salmeterol, and adverse reactions to all the treatments were infrequent and mild. CONCLUSIONS: For the management of mild-to-moderate asthma, salmeterol given twice daily is superior to albuterol given either four times daily or as needed.

Administration, Inhalation↗

PubMed1979

Albuterol and isoproterenol in bronchial asthma. Efficacy and toxicity of drugs administered via intermittent positive pressure breathing.

This study compared the efficacy and side effects of 1.25, 2.5, 5, 10, and 15 mg of albuterol and isoproterenol hydrochloride administered by intermittent positive pressure breathing (IPPB) to 12 patients with reversible airway obstruction. Equal doses of the two medications induced similar peak increases in pulmonary function, but the increase following albuterol persisted longer. The degree of bronchodilation was impressive; 15 mg of albuterol induced a mean increase over six hours of 82% in the forced expiratory volume in one second. Significant cardiovascular side effects were more common after isoproterenol than after albuterol. Albuterol is superior to isoproterenol as a bronchodilator when administered by IPPB because, for a given peak bronchodilation, cardiovascular side effects are fewer and bronchodilation persists longer with albuterol. The optimal dose of isoproterenol hydrochloride is 2.5 to 5.0 mg and the optimal dose of albuterol is 10 mg when these drugs are given by IPPB.

Adult↗

PubMed1992

Enhancement of theophylline clearance by oral albuterol.

The possible effect of albuterol on theophylline clearance was studied in ten adult volunteers. Subjects received intravenous aminophylline loading dose (5.6 mg/kg), with oral albuterol (4 mg every 6 h), or inhaled albuterol (200 micrograms every 6 h), or alone (control). Theophylline levels were determined for 12-h periods. Theophylline clearance and elimination t 1/2 were calculated. Theophylline clearance was significantly higher when given with oral albuterol, in comparison with control (0.83 +/- 0.05 vs 0.73 +/- 0.06 ml/kg/min, p less than 0.02). Theophylline elimination t 1/2 was shorter with the coadministration of oral albuterol, compared with control (7.1 +/- 0.3 vs. 8.1 +/- 0.6 h, p less than 0.02). These alterations in theophylline clearance and elimination were greater in subjects who had lower control theophylline clearance. Theophylline clearance and elimination t 1/2 recorded with inhaled albuterol were not significantly different from control values. Coadministration of oral albuterol and theophylline resulted in enhancement of theophylline clearance, particularly in subjects with initially slow theophylline elimination. Such patients may require theophylline dosage adjustment as a result of this interaction.

Administration, Inhalation↗

PubMed1992

The use of nebulized albuterol in wheezing infants.

Using a double-blind, placebo-controlled protocol, we evaluated the efficacy of nebulized albuterol in the treatment of infants aged 0 to 24 months who presented to the emergency department with wheezing. Twenty-five infants were randomly assigned to receive two identical treatments of either nebulized albuterol (0.15 mg/kg) or placebo (saline). Assessment after each treatment included a wheeze and retraction score, respiratory and heart rates, and pulse oximetry. After two treatments, there was a significant improvement in the wheeze scores (P less than 0.05) and total scores (P less than 0.05) of the albuterol group compared with the placebo group. After one treatment, there was an initial decrease in oxygen saturation in the albuterol group, which improved after the second treatment. There were no significant differences between the two groups in heart rate or respiratory rate. This study supports the use of nebulized albuterol in the treatment of wheezing infants in the emergency department.

Albuterol↗

PubMed1992

Transdermal drug delivery systems of albuterol: in vitro and in vivo studies.

In vitro and in vivo experiments were conducted with double- and single-layer albuterol transdermal pads designed for once-a-day application. In the in vitro experiments, dissolution of albuterol from pads and permeation of albuterol through hairless mouse skin were monitored. In the in vivo experiments, pads were applied to the chest area of four female rhesus monkeys (Macaca mulata), and an albuterol aqueous solution was injected into the saphenous vein of the same animals in a crossover design. The amount lost from pads applied to monkeys was monitored by analysis of pad residue. Blood samples were withdrawn at regular intervals and analyzed by a high-performance liquid chromatography-fluorescence method. Skin irritation due to the pad was measured by a modified Draize score test. The amounts released from the two formulations were similar. The amount released was, however, dependent on the technique used and decreased in the following manner: pad dissolution greater than in vivo amount lost from pads applied to monkeys greater than in vitro permeation through hairless mouse skin. The pharmacokinetic parameters determined after intravenous and transdermal administration were as follows: terminal half-life, 2.26 +/- 0.45 h; apparent volume of distribution, 1935 +/- 37.2 mL.kg-1; and total body clearance, 612.0 +/- 118 mL.h-1.kg-1. The average concentrations in serum after application of single- and double-layer pads were 44.60 +/- 16.40 and 62.50 +/- 8.00 ng/mL, respectively. Further, the amount lost from pads applied to monkeys correlated with the respective amount absorbed in monkeys, as calculated from the average concentration in serum and clearance.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Cutaneous↗

PubMed1992

Salmeterol, a new inhaled beta 2-adrenergic agonist, has a longer blocking effect than albuterol on hyperventilation-induced bronchoconstriction.

The duration of the blocking effect of salmeterol (50 micrograms), albuterol (200 micrograms), and a placebo were compared in a double-blind study in 12 adult subjects with asthma who underwent hyperventilation tests with cold dry air (-20 degrees C) on 4 study days. On the first day, the hyperventilation test was performed at various time intervals (baseline, 1, 4, 6, 8, 12, and 24 hours) with spontaneous functional recovery between each test to determine the within-day within-subject variability of the response. The response was assessed by interpolating the dose of cold dry air causing a 20% fall in FEV1. On the 3 remaining days, separated by an interval of at least 5 days, the active or placebo medication was administered after spontaneous recovery from the first hyperventilation test. Spirometry was assessed 15 minutes and 1 hour later. The hyperventilation test was then performed and repeated 4 hours after administration of the drug. The test was repeated 6, 8, 12, and 24 hours later to detect any significant blocking effect. The improvement in FEV1 15 minutes and 1 hour after the drug was administered was 19.8% and 20.4%, as compared to baseline for albuterol, and 16.3% and 16.8% for salmeterol (not significant). The mean duration of the blocking effect was 0.25 hour for the placebo, 3.5 hours for albuterol, and 15.9 hours for salmeterol (F = 24.5; p less than 0.001; Newman-Keul's test was significant for every contrast). Eight of the 12 subjects still demonstrated some blocking effect 8 hours after taking salmeterol; this was true for only one subject receiving albuterol.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1979

Influence of albuterol on erythropoietin production and erythroid progenitor cell activation.

The effect of albuterol, a potent beta2-adrenergic agonist, on kidney production of erythropoietin (Ep) was studied. Its effects on erythroid colony (CFU-E) formation in vitro in rabbit bone marrow cultures were also assessed. Albuterol produced a significant increase in plasma Ep levels in conscious rabbits following 7 h intravenous infusion (50 (microgram/kg)/min). This effect was blocked by pretreatment of the rabbits with butoxamine (5 mg/kg ip), a potent beta2-adrenergic blocker. Albuterol in doses of 10(-10) to 10(-8) M in combination with Ep was also found to produce a significant increase in the numbers of CFU-E in the plasma clot culture system of rabbit bone marrow. This effect was blocked completely by DL-propranolol (10(-8) M) and by butoxamine (10(-8) M). The data presented suggest that albuterol, a potent activator of beta2-adrenergic receptors, increases kidney production of Ep in vivo and also produces a direct effect in combination with Ep on the proliferation of the erythroid progenitor cell compartment.

Albuterol↗

PubMed1978

Cardiac and pulmonary effects of therapy with albuterol and isoproterenol.

This study evaluated the cardiac and pulmonary effects of administering multiple inhaled doses of albuterol, isoproterenol sulfate, and placebo in ten patients with reversible obstructive disease of the airways. The pulmonary effects of therapy with albuterol were similar in magnitude to those of isoproterenol but lasted longer. The inotropic and chronotropic effects of therapy with isoproterenol were greater than those of albuterol. It appears that albuterol has beta2-adrenergic selectivity over a wide range of dosages and is an effective bronchodilator drug.

Adolescent↗

PubMed1992

Efficacy of adding nebulized ipratropium bromide to nebulized albuterol therapy in acute bronchiolitis.

Nebulized ipratropium bromide is though to be synergistic with albuterol in therapy for acute childhood asthma. Because the efficacy of ipratropium in bronchiolitis is uncertain and some infants with bronchiolitis do not respond to nebulized albuterol alone, the following study was undertaken. In this double-blind, placebo-controlled trial, 69 infants between 6 weeks and 24 months of age who exhibited the first episode of acute bronchiolitis were randomly assigned to receive either nebulized albuterol (0.15 mg/kg per dose) and ipratropium bromide (250 micrograms per dose) (group A, n = 36) or nebulized albuterol and normal saline (placebo) (group B, n = 33) for two doses, 1 hour apart. The two groups were comparable at baseline. Both therapies resulted in clinically significant improvement. However, the addition of ipratropium resulted in no additional benefit with respect to decrease in the respiratory rate (mean decreases 10.6/min vs decreases 8.6/min, P = .86), accessory muscle score (range 0 through 3) (decreases 0.92 vs decreases 0.82, z = -0.44), wheeze score (range 0 through 3) (decreases 0.94 vs 0.85, z = -0.20), oxygen saturation (increases 0.25% vs increases -0.33%, P = .86), or hospitalization rate (17 vs 10). The number of "nonresponders" and "clear responders" was also very similar in both groups. No toxicity was noted. The increase in heart rate was mild and similar in both groups (increases 6.7 vs increases 11.1). The power of the study to detect a difference between the two treatment groups in the respiratory rate change > or = 8/min is greater than 90%.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

PubMed1992

The prehospital use of nebulized albuterol on patients with wheezing whose chief complaint is shortness of breath.

The use of prehospital nebulized beta-agonists has become widespread, and their safety and efficacy has been documented. Our purpose was to study their broadened use and determine their effectiveness in specific sub-sets of wheezing patients. We conducted a six and one-half month prospective study to determine the benefit of nebulized albuterol treatments on a variety of wheezing patients whose chief complaint to paramedics was shortness of breath. Sixty-two patients were enrolled in the study and were subdivided into four groups based on patient history; asthma, COPD, asthma & COPD (A/C), and non-Asthma/non-COPD (NANC). The effectiveness of the treatment was evaluated objectively by peak expiratory flow rates (PEFR) obtained before and immediately after treatment and subjectively by the patients' evaluation of their own dyspnea. Changes in PEFR were subjected to analysis by a paired T-test. Albuterol was effective in increasing the PEFR in patients with asthma, COPD and NANC. Patients with both asthma and COPD did not demonstrate increased PEFR after treatment. The majority of all patients were subjectively improved after nebulized albuterol treatments. We conclude that aerosolized albuterol is safe and effective in the prehospital treatment of patients complaining of dyspnea who are wheezing.

Adult↗

PubMed1975

Effect of albuterol and terbutaline, synthetic beta adrenergic stimulants, on the cyclic 3',5'-adenosine monophosphate system in smooth muscle.

The effect of albuterol and terbutaline on the cyclic 3',5'-adenosine monophosphate (cAMP) system was studied in rat uterus, aorta and myocardium and in dog bronchus, and was compared to that of isoproterenol in order to determine whether the tissue specificity observed in their functional effects is reflected in their effect on the cAMP system. Tissue specimens were either homogenized in Tris buffer for enzyme activity measurements or incubated in Krebs-Ringer-bicarbonate medium with the test drugs. Both albuterol and terbutaline produce an increase in cAMP content in the tissues due to a direct effect on adenylate cyclase. This effect can be potentiated by a phosphodiesterase inhibitor and antagonized by a beta adrenergic blocking compound. The cAMP response to each beta adrenergic agonist differs in the tissues examined: in uterus and aorta where the maximal effects are idenitcal, the ED50 values may reflect differences in affinity which may account for the different cAMP response to the compounds at the lower concentrations. In bronchus and myocardium, both the maximum effect and ED50 values of the compounds are different. Albuterol and terbutaline increases cAMP content in bronchus significantly and have only a small effect on cAMP cont in myocardium, whereas isoproterenol increases cAMP level significantly in both tissues. The results indicate that the tissue specificity of albuterol and terbutaline may have its origin at the level of the cAMP system.

Adenosine Triphosphate↗

PubMed1977

Comparative study of acute effects of albuterol and isoproterenol sulphate aerosols in bronchial asthma.

Albuterol, a new bronchodilator drug known to cause beta2-adrenergic receptor stimulation, was compared with isoproterenol sulphate for their pulmonary and cardiovascular effects in patients suffering from bronchial asthma. In a double-blind manner 24 patients received as aerosol 170 micrograms of Albuterol or 150 micrograms of Isoproterenol or placebo on three different days. Spirometric, plethysmographic, heart rate and blood pressure measurements were made at 1, 5, 15, 30, 60, 90, 120, 300 and 360 minutes after drug inhalation. Baseline values for the various indices were not significantly different before administration of the drugs. Results demonstrate that Albuterol is an effective bronchodilator and its bronchodilating effect is significantly superior and of longer duration than that of Isoproterenol. Albuterol did not produce any significant changes in blood pressure and pulse rate, thus confirming its selectivity for beta2 receptors.

Aerosols↗

PubMed1977

Subsensitivity to the bronchodilator action of albuterol produced by chronic administration.

Evidence of bronchodilator subsensitivity was sought in studies using the specific beta2 adrenergic agonist, albuterol. After a period of 1 or 2 weeks off all oral sympathomimetic agents, the mean response of the patients to the first dose of albuterol was consistently greater than the response after a period during which the drug had been administered regularly. Maximal decrease in response occurred after 2 weeks' of treatment, and there was no further decrease after prolonged treatment with the same dose of albuterol for periods as long as 1 year.

Adolescent↗

PubMed1978

Clinical comparison of fenoterol and albuterol administered by inhalation. A double-blind study.

The effects of inhaling 0.4 mg of fenoterol hydrobromide (Berotec), 0.2 mg of albuterol (salbutamol), or placebo were compared in a double-blind three-way crossover study in a group of 12 asthmatic patients. After inhalation of fenoterol, the maximum increase in the forced expiratory volume in the first second (FEV1) was 0.76 L (48 percent) and in the peak expiratory flow (PEF) was 100 L/min (47 percent). The corresponding figures after inhalation of albuterol were 0.68 L (46 percent) and 98 L/min (48 percent), respectively. In comparison with administration of placebo, the FEV1 was significantly increased until six hours after inhalation of either drug. From three to six hours after inhalation, the effect of administration of fenoterol (as measured by FEV1 or PEF) significantly exceeded that of albuterol. Administration of either drug resulted in approximately equal bronchodilation (as measured by the increase in FEV1 or PEF), the effect of inhalation of fenoterol being of longer duration.

Adolescent↗

PubMed1992

The effect of repeat action albuterol sulfate (Proventil Repetabs) in nocturnal symptoms of asthma.

At four medical centers, 98 patients with stable asthma, histories of nighttime awakening at least three times weekly and nighttime declines of pulmonary function of at least 15%, who were not taking oral adrenergic agonists, were randomly treated with either oral repeat-action albuterol sulfate (Proventil Repetabs), 4 mg in the morning and 4-16 mg at bedtime, or a placebo for 2 weeks. All patients were required to have nocturnal symptoms of asthma, with prior use of bronchodilators other than oral adrenergic agonists to be eligible for the study. The patients maintained a diary of asthma symptom scores and recorded peak flow rates at home at bedtime and in the morning. They had spirometry (FEV1, FVC, and PEFR) after a 1-week baseline stabilization period, and after 1 and 2 weeks of double-blind oral therapy as noted above. Efficacy was evaluated by changes in the bedtime and morning peak flow rates, changes in the number of nighttime awakenings, results of office spirometry testing, and by physician and patient global evaluations of response to therapy. Of the 98 patients in the study, 47 received oral albuterol, and 51 received placebo. The patients on albuterol had a statistically significant reduction in the number of nighttime awakenings (p less than or equal to 0.01), as compared with the patients on placebo; this included both the average number of awakenings per week (p = 0.04), and the mean number of nights with awakenings per week (p = 0.04).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1975

Exercise-induced bronchospasm: evaluation of albuterol aerosol.

Albuterol aerosol was compared with isoproterenol and placebo in a double-blind, cross-over study in 12 asthmatic children. A significant increase in mean peak expiratory flow rate 15 minutes after albuterol inhalation persisted for at least five hours after treatment. Inhalation of albuterol one hour before treadmill exercise inhibited exercise-induced bronchospasm.

Adolescent↗

PubMed1977

Albuterol and ephedrine in patients with reversible obstructive airway disease.

This study evaluated the cardiac, pulmonary and neuromuscular effects of albuterol and ephedrine. The pulmonary effects of albuterol occurred earlier, lasted longer and were greater in degree. The cardiac effects of both drugs were virtually non-existent. Tremor was recorded with the higher doses of albuterol.

Airway Obstruction↗