Chest, Vol 105, 1738-1742, Copyright © 1994 by American College of Chest Physicians

ARTICLES

Dose-effect relationship of the beta-agonists fenoterol and salbutamol in patients with asthma

MT Newhouse, MB Dolovich and F Kazim
Barnett Medical Aerosol Research Laboratory, St. Joseph's Hospital/McMaster University, Hamilton, Ontario, Canada.

QUESTION: What is the relative per microgram potency and side effect profile of the beta-agonists salbutamol and fenoterol? METHOD: The relative bronchodilator (delta FEV1, V25, V50) potency and side effect profile (delta tremor, heart rate, breathlessness, BP) of nebulized salbutamol and fenoterol were evaluated by means of a randomized, double-blind, crossover, cumulative (50 to 2,500 micrograms) dose- response study. Both beta-agonists were administered to 12 patients with stable asthma over age 18 years with baseline FEV1 between 35 to 70 percent predicted. RESULTS: (1) Salbutamol and fenoterol both provided significant bronchodilatation compared with baseline. (2) There was no dose-effect difference between the two beta-agonists with respect to bronchodilator response. (3) Overall there was no significant difference between the side effect profiles of the two beta- agonists, although at the highest dose of fenoterol, there was marginally greater tremor when measured by accelerometry. (4) There was no difference in the vital signs or subjective patient evaluations of tremor, palpitations, or breathlessness as estimated by a visual analogue scale. (5) No significant adverse reactions occurred. SUMMARY AND CONCLUSION: Equivalent bronchodilatation and similar side effect profiles were measured in a group of patients with stable asthma after treatment with nebulized salbutamol or fenoterol in the dose range 50 to 1,250 micrograms (cumulative, 2,500 micrograms). This indicates that both beta-agonists have similar per microgram potency and side effect profiles. Observed clinical differences in response or side effects associated with fenoterol metered-dose inhaler administration may be a result of its higher dose per puff metered-dose inhaler formulation.

This article has been cited by other articles:

				H. A. M. Kerstjens, T. A. Bantje, P. B. Luursema, H. E. J. Sinninghe Damste, J. W. de Jong, A. Lee, S. P. C. Wijker, and P. J. G. Cornelissen Effects of Short-Acting Bronchodilators Added to Maintenance Tiotropium Therapy Chest, November 1, 2007; 132(5): 1493 - 1499. [Abstract] [Full Text] [PDF]

				L. D. Lynd, D. P. Guh, P. D. Pare, and A. H. Anis Patterns of Inhaled Asthma Medication Use: A 3-Year Longitudinal Analysis of Prescription Claims Data From British Columbia, Canada Chest, December 1, 2002; 122(6): 1973 - 1981. [Abstract] [Full Text] [PDF]

				B J LIPWORTH Revisiting interactions between hypoxaemia and {beta}2 agonists in asthma Thorax, July 1, 2001; 56(7): 506 - 507. [Full Text] [PDF]

				D. FISHWICK, L. BRADSHAW, C. MACDONALD, R. BEASLEY, D. GASH, T. BENGTSSON, E. BONDESSON, and L. BORGSTRÖM Cumulative and Single-dose Design to Assess the Bronchodilator Effects of {beta}2-Agonists in Individuals with Asthma Am. J. Respir. Crit. Care Med., February 1, 2001; 163(2): 474 - 477. [Abstract] [Full Text]