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At least 19 recordsLinked to original sources

Comparison of metaproterenol, isoetharine and salbutamol in the relief of methacholine-induced bronchospasm in dogs.

We evaluated cardiovascular effects and effectiveness of isoetharine, metaproterenol and salbutamol, when administered intratracheally to relieve methacholine-induced bronchospasm in dogs anaesthetized with 50 per cent nitrous oxide, oxygen, halothane and mechanically ventilated. Methacholine 2 micrograms X kg-1 X hour-1 was administrated first followed by halothane (1 MAC) for 30 minutes (control), then metaproterenol, isoetharine or salbutamol. Metaproterenol (15 mg) significantly decreased transpulmonary pressure to 20.1 +/- 0.5 (SE) from 22.5 +/- 1.15 cmH2O (p less than 0.025) after three min and to 15 +/- 0.5 cmH2O (p less than 0.005) after 90 min. Isoetharine (2.5 mg) decreased transpulmonary pressure after five min to 22.1 +/- 1 from 24.5 +/- 1.5 cmH2O (p less than 0.05), and to 21.75 +/- 0.55 mmH2O after 90 min. Salbutamol 25 micrograms X kg-1 decreased transpulmonary pressure to 20.7 +/- 0.75 from 24.25 +/- 1.28 after three min and to 16 +/- .5 after 90 min. The peak effects on airway pressure occurred at 15 min for metaproterenol, 25 min for salbutamol and 20 min for isoetharine. Pulmonary vascular resistance was not significantly changed during halothane anaesthesia alone but decreased significantly after metaproterenol and isoetharine infusion. Heart rate increased ten per cent after metaproterenol, three per cent after isoetharine, and five per cent after salbutamol. No arrhythmias occurred in any group. Cardiac output increased significantly to 3.25 +/- 0.2 from 1.5 +/- 0.17 L X min-1 (p less than 0.025) after metaproterenol to 3.2 +/- .025 from 1.45 +/- .009 after salbutamol and was unchanged after isoetharine. Metaproterenol and salbutamol in the presence of 1 MAC halothane anaesthesia relieved methacholine-induced bronchospasm more rapidly than did isoetharine. The onset of effect was 3 +/- 0.05 min for metaproterenol and salbutamol and 5 +/- 0.01 min for isoetharine. The effect lasted 210 +/- 10.5 min for metaproterenol, 170 +/- 12.5 min for salbutamol and 90 +/- 4.75 min for isoetharine.

Airway Resistance↗

Aerosol bronchodilator therapy: a comparison of the effects of bronkometer with isoetharine, isoproterenol and phenylephrine.

The bronchodilator action and cardiovascular toxicity of aerosols of (1) isoetharine, (2) isoetharine in combination with phenylephrine, (3) isoproterenol, and (4) phenylephrine were compared in a group of severe stable ambulatory asthmatics. All preparations except phenylephrine produced reduction in specific airway resistance and increased flow rates which peaked at 15 minutes. The action of isoproterenol and the two isoetharine preparations peaked at 15 minutes while the peak effect of isoetharine and isoetharine in combination with phenylephrine continued for 60 minutes. The difference between isoproterenol and isoetharine alone or in combination with phenylephrine was not statistically significant. None of the drugs produced any cardiovascular side effects. The authors conclude that isoetharine, though less potent than isoproterenol on a weight-for-weight basis, is an effective and safe bronchodilator. Addition of phenylephrine to isoetharine does not potentiate or prolong the action of the latter.

Adult↗

A randomized, controlled comparison of isoetharine and albuterol in the treatment of acute asthma.

STUDY OBJECTIVE: To determine whether treatment of acute asthma with repeated doses of nebulized albuterol leads to greater bronchodilation and lower hospital admission rate than treatment with nebulized isoetharine. DESIGN: Randomized, double-blinded, controlled trial of albuterol and isoetharine. TYPE OF PARTICIPANTS: Patients between 18 and 50 years old presenting with acute asthma. Patients were excluded if they had a history of sensitivity to the study drugs, had congestive heart failure or chronic-obstructive pulmonary disease, or were unable to perform spirometry. One hundred three patients were entered into the study. INTERVENTIONS: All patients received oxygen and methylprednisolone in addition to administration of either isoetharine or albuterol. The nebulized aerosol was given at hourly intervals for a total of three doses. MEASUREMENTS AND MAIN RESULTS: Spirometry was performed before treatment and again at 90 and 180 minutes. Initial forced expiratory volume at one minute (FEV1) was 38.1% of predicted normal for the albuterol group and 36.0% of predicted normal for the isoetharine group. At 180 minutes, FEV1 was 55.6% of predicted normal for the albuterol group and 57.1% of predicted for the isoetharine group (NS). Twenty-eight percent of the albuterol group required admission compared with 26% of the isoetharine group (NS). There was no difference in occurrence of side effects between the two groups. CONCLUSION: Repeated doses of albuterol do not lead to a greater improvement in pulmonary function or a lower hospital admission rate than treatment with isoetharine.

Adolescent↗

Isoetharine versus albuterol for acute asthma: greater immediate effect, but more side effects.

PURPOSE: To compare the magnitudes of the immediate effects of the nebulized beta-agonists isoetharine and albuterol in the treatment of acute severe asthma. PATIENTS AND METHODS: Fifty-one adults presenting with severe asthma exacerbations (forced expiratory volumes in the first second of exhalation [FEV1] <40% of predicted) to the emergency department were randomized (double-blind) to receive hourly inhaled nebulization treatment with either isoetharine (5 mg) or albuterol (2.5 mg). The FEV1 was measured immediately before and after each nebulized treatment. Any side effects were recorded. RESULTS: Immediately after the first nebulized treatment, the isoetharine group improved its mean FEV1 (+/-SEM) by a significantly greater amount than did the albuterol group: 60% +/- 11% versus 39% +/- 5%, respectively (P <0.05). One hour later the mean FEV1 were equivalent. This pattern repeated itself after the second hourly treatment. The two groups did not differ in any outcome parameters (FEV1 at discharge, number of nebulized treatments required, the number of inpatient admissions, number of clinical relapses after discharge). More patients treated with isoetharine had side effects (36% versus 4% for albuterol, P <0.01), 1 of whom required discontinuation from the study. CONCLUSIONS: Both medications were equally effective in alleviating bronchospasm. The immediate effect of isoetharine was significantly greater, but equalized that of albuterol within an hour after treatment. There were more side effects with isoetharine.

Acute Disease↗

Effect of isoetharine on cardiac conduction in man.

The effects of isoetharine on the His bundle electrogram were studied in 10 patients with heart disease. Recordings were made at varied heart rates using atrial pacing. Isoetharine significantly reduced the AH interval with atrial pacing, but it had no effect on the HV interval. Second degree heart block occurred at higher pacing rates after isoetharine treatment as compared to the control state. The heart rate and blood pressure showed no significant change after isoetharine. The functional and effective refractory period were measured with the use of the extra-stimulus technique. The functional refractory period of the AV node, as well as the effective refractory period of the atrium, significantly decreased after isoetharine. Thus, isoetharine can improve conduction through the atrioventricular node. The drug does have a cardiac effect as measured by its action on the human conduction system.

Adrenergic beta-Agonists↗

Comparison of the effects of isoprenaline, orciprenaline, salbutamol and isoetharine on the cardiovascular system of anaesthetized dogs.

1. The intravenous injection of isoprenaline, orciprenaline, salbutamol and isoetharine increased heart rate in anaesthetized dogs. Log dose-response curves obtained with a series of doses of salbutamol and isoetharine were flatter than those for isoprenaline and orciprenaline. The order of activity of the drugs in increasing heart rate was isoprenaline, orciprenaline, and salbutamol=isoetharine.2. The injection into the external iliac artery of isoprenaline, orciprenaline, salbutamol and isoetharine produced dose dependent increases in femoral blood flow. Log dose-response curves for all drugs were parallel. The order of activity of the drugs was isoprenaline, salbutamol=isoetharine and orciprenaline.3. Salbutamol and isoetharine were less active than orciprenaline in increasing heart rate but more active in increasing femoral blood flow.4. These observations indicate that salbutamol and isoetharine have a greater effect on beta(2) than on beta(1)-adrenoceptors in the cardiovascular system.

Amino Alcohols↗

Clinical comparison of albuterol, isoetharine, and metaproterenol given by aerosol inhalation.

The clinical effectiveness of albuterol, isoetharine, and metaproterenol administered by aerosol inhalation at manufacturer-recommended doses was compared. A double-blind, placebo-controlled, crossover comparison of albuterol 280 micrograms, isoetharine 680 micrograms, and metaproterenol 1300 micrograms was conducted in 10 adult men with reversible, chronic pulmonary obstruction. FEV1 (forced expiratory volume at one second), FEF25-75 (forced expiratory flow rate from 25 to 75% of vital capacity), and FVC (forced vital capacity) were determined periodically for six hours after drug administration. Bronchodilator effects, adverse effects, and cost of treatments were compared. Theophylline therapy was unaltered during the study, and serum theophylline concentration was determined periodically to control for its effect on pulmonary function. Serum theophylline concentration was not used as a covariate since it resulted in minimal change in the pulmonary-function measures. The mean maximum percent change from baseline for FEV1 for each drug was superior to placebo; there were no differences among drugs. Comparing area under the curve of mean percent change in FEV1 versus time, albuterol and metaproterenol produced changes that were greater than placebo but not different from each other or isoetharine. For FEF25-75 and FVC, albuterol and metaproterenol, respectively, were superior. No pattern of adverse effects was identifiable among the four treatments. The average wholesale cost of albuterol products was approximately 1.7 times the cost of metaproterenol products. Under the conditions of this study, metaproterenol was superior to isoetharine and therapeutically equivalent to and less expensive than albuterol.

Aerosols↗

Determination of isoetharine in plasma by reversed-phase chromatography with amperometric detection.

A reversed-phase liquid chromatographic method for the determination of isoetharine in blood plasma, utilizing amperometric detection, is described. Plasma samples were extracted utilizing an ion-pair reagent, di-(2-ethylhexyl)phosphoric acid, to concentrate the catecholamine. Only minor differences were observed in the relative bioavailability of isoetharine hydrochloride and isoetharine mesylate after oral administration to rats. Observed plasma levels, at 1 hr after oral medication, were highly variable in dose-ranging studies at doses of 800-2500 mg/kg/day for 2 weeks.

Administration, Oral↗

A controlled trial of nebulized isoetharine in the prehospital treatment of acute asthma.

Acute asthma is a potentially life-threatening disorder, recognizable to the prehospital care provider. While therapies are available to the prehospital care provider for treating acute asthma, no previous controlled studies have been performed demonstrating the treatment in the field is efficacious and safe. The authors conducted a controlled trial of the prehospital use of nebulized isoetharine in an urban emergency medical services system. Fifty-two patients with acute asthma were studied. Patients were initially evaluated with a peak flow meter. Half of the patients received isoetharine, while the control group received basic life support only. There was no difference in baseline values. Peak expiratory flow increased from 138 L/min to 148 L/min in the control group, while it increased from 149 L/min to 218 L/min in the treatment group (P less than .001). The authors conclude that paramedic treatment of acute asthma with nebulized isoetharine is effective in improving pulmonary function and clinical status during transport.

Acute Disease↗

Double-blind comparison of metaproterenol and isoetharine-phenylephrine solutions in intermittent positive pressure breathing in bronchospastic conditions.

A 5 percent solution of metaproterenol sulfate (Alupent) and a fixed-combination solution of isoetharine and phenylephrine were compared in a single-dose double-blind study in a total of 27 patients with reversible bronchospastic disease. The patients were assigned to parallel groups for treatment and received the usual dose of 0.3 ml of metaproterenol and 0.5 ml of the isoetharine-phenylephrine solution via equipment for intermittent positive-pressure breathing. Tests of pulmonary function, blood pressure, and pulse rate were performed before the treatment and at intervals of 30 minutes to six hours after administration. The duration of effect (defined as an increase over baseline in the forced expiratory volume in one second [FEV1] of at least 15 percent) of metaproterenol averaged four hours, as compared with one hour for the reference solution. The overall response of FEV1 to metaproterenol was significantly (P = 0.01) superior to the response to the isoetharine-phenylephrine solution. Metaproterenol also surpassed the reference drug in terms of increases in the mean forced expiratory flow during the middle half of the forced vital capacity (FEF-25-75%) to a degree approaching statistical significance. Changes in blood pressure and pulse rate were clinically insignificant with both drugs, and the total number of adverse experiences was substantially the same with both solutions.

Adult↗

Isoetharine-isoproterenol: a comparison of effects in childhood status asthmaticus.

Eighteen children in status asthmaticus, six to 14 years of age, were systematically studied to compare the efficacy of aerosolized isoetharine and isoproterenol. The studies were conducted in a randomized, double-blind fashion. Five inhalations of 1% isoetharine and 0.5% isoproterenol were administered via a wall-mounted air/O2 nebulizing unit. Pulse, respiratory rate, blood pressure, FVC, PEFR, FEV1 and FEF25-75 were measured at the patient's bedside. Isoetharine produced significantly less cardiac side effect and tended to produce a greater improvement in pulmonary function than did isoproterenol. In addition, no change from baseline was noted in any of the parameters at 120 minutes following treatment with either medication.

Adolescent↗

Nebulized isoetharine and fenoterol in acute attacks of asthma.

Nebulized, selective beta 2-adrenergic agents were shown to be a safe and effective alternative to subcutaneous epinephrine chloride in the treatment of acute asthma attacks. Results of a trial of nebulized 1% isoetharine hydrochloride and 0.5% fenoterol in 40 patients with acute attacks of wheezing is reported. Both groups showed significant improvement on forced expiratory volume in one second (FEV1), maximum expiratory flow at 25% and 50% vital capacity but those who received fenoterol therapy showed more significant bronchodilation after one hour. Based on clinical criteria and the ability to raise and maintain for four hours an FEV, by 15% above baseline, ten (50%) of the patients who received isoetharine and 16 (80%) of the patients who received fenoterol therapy were successes. Mild side effects were encountered in eight patients of each treatment group. Fenoterol therapy was significantly more effective and had a longer duration of action.

Acute Disease↗

Comparison of fenoterol, isoproterenol, and isoetharine with phenylephrine aerosol in asthma.

The bronchodilator effect of fenoterol hydrobromide (0.5, 1.25, and 2.5 mg) was compared with either isoproterenol (2.8 mg) or isoetharine (5 mg) with phenylephrine (1.25 mg) in a double-blind placebo-controlled study. When delivered by an intermittent positive-pressure breathing device to 24 nonsmoking young adult asthmatic subjects, fenoterol produced significant improvement in forced expiratory volume at 1 second (FEV1), in maximum midexpiratory flow (FEF25-75%), and in forced expiratory flow at 25 per cent of vital capacity (FEF25%) for 6 to 8 hours, whereas isoproterenol and isoetharine with phenylephrine produced improvement for 1 and 2 hours, respectively. The lowest dosage of fenoterol was as effective as the highest but had fewer adverse effects.

Adolescent↗

Chemical stabilities of isoetharine hydrochloride, metaproterenol sulphate and terbutaline sulphate after mixing with normal saline for respiratory therapy.

The chemical stabilities of isoetharine hydrochloride inhalation solution, metaproterenol sulphate inhalation solution and terbutaline sulphate injection, after diluting 1 in 10 with sodium chloride 0.9% injection were studied. On storing the solutions in amber-coloured syringes, they were stable for at least 120 days at 5 degrees C. At 25 degrees C they were also stable for 120 days except that isoetharine solution discoloured and lost 7.8% of its potency after 90 days of storage. There was a new peak in the chromatogram from the decomposition product. All other solutions remained clear for 120 days at both temperatures. The initial and final pH values were similar except that after 120 days at both temperatures. The initial and final pH values were similar except that after 120 days at 25 degrees C, the pH value of terbutaline solution had increased from 4.9 to 5.4.

Amino Alcohols↗

Clinical study of broncholytic effect and side-effects of isoetharine ('Numotac').

In thirty-nine adult asthmatics a clinical trial was carried out with 10 mg slow-release tablets of isoetharine ('Numotac', 3M Riker) at two dose levels: 10 mg and 20 mg four times a day. The trial was double-blind with crossover after six weeks. Twenty-three patients reported a positive effect on their respiratory symptoms when isoetharine had replaced their previous treatment; negative effect was reported by one patient while twelve patients were undecided. Tremor was a common side-effect but except in three cases it was slight. There was no difference in side-effects between the high and the low doses if the initial dose was low. However, there were significantly more side-effects when the trial was started with the high dose.

Adult↗

Combination of atropine and isoetharine aerosol therapy in pediatric acute asthma.

Seventeen hospitalized children with acute asthma, ages 7 to 15 years, were studied to determine the efficacy of simultaneous administration of atropine sulfate and isoetharine. Combination therapy was superior in 11/17 (65%) patients while isoetharine alone was superior in 4/17 (23%) patients (P = .037). We conclude that simultaneous administration of combination therapy is safe and beneficial in some children with acute asthma.

Acute Disease↗

A study of isoetharine mesylate in patients with chronic bronchial asthma.

We performed a double-blind, random crossover study to investigate the respiratory effects of a single dose isoetharine mesylate (IM), administered by a metered aerosol canister in 19 subjects with mild, stable asthma. In addition, we studied the influence of the dose (number of actuations) and the mode of administration (delay between actuations) on these respiratory effects. The protocol consisted of a screening day and four test days: (1) one inhalation IM (2) two inhalations IM (3) one inhalation placebo (P), and (4) two inhalations P. In addition, the first nine asthmatics paused one minute between inhalations whereas the last ten paused five minutes between inhalations. Lung function was assessed using maximal and partial expiratory flow volume curves. Measurements were taken prior to aerosol delivery and for six hours after aerosol. Significant differences between IM and P were seen for up to two hours. The maximum effect was observed at 15 minutes, corresponding to a 23% and 25% increase in FEV1 from baseline with one and two puffs, respectively (P less than .001). The differences between one and two actuations were, in general, not significant. No significant differences were observed between individuals who waited one versus five minutes between inhalations. We conclude that IM aerosol results in significant improvement compared with placebo for two hours. Differences between one and two inhalations and the interval between two inhalations did not, in general, lead to enhanced effectiveness of this drug in the group of asthmatics studied.

Adolescent↗

Hypomania related to phenelzine and isoetharine interaction in one patient.

A case is reported of a man with apparent unipolar depression that was responsive to treatment with phenelzine who became hypomanic when isoetharine was added to treat his chronic obstructive pulmonary disease. The role of beta-adrenergic receptors in affective illness is reviewed in light of this case.

Aged↗