SELECTED ARTICLES FROM THE RECENT LITERATURE 2004
12/28/04
Long acting beta 2 agonists in asthma exacerbations
Summary
Background - Acute asthma exacerbations (AAE) are major cause of morbidity and asthma related expenses. The value of inhaled long acting beta agonists (LABA) such as salmeterol (Sal) or formoterol (Form) has been shown in the maintenance therapy of persistent asthma. However, the potential role of LABA in treatment of AAE is not yet well defined.
Findings - Hospenthal and Peters of the University of Texas in San Antonio reviewed recent literature dealing with use of LABA in the treatment of AAE. Since the onset of bronchodilatation is as rapid with Form as with albuterol, Form has been approved as a reliever medication in several European countries. Related to this is evidence supporting the use of Form in the outpatient management of mild AAE. The addition of Sal to conventional therapy has been shown to be safe and potentially beneficial in patients hospitalized with an AAE.
Reference
Curr Opin Pulm Med 2005;11:69-73
Editor's Comments
I have been impressed with the clinical effects of inhaled Form, with onset of bronchodilatation as rapidly as with inhaled albuterol (within a few minutes), yet duration of such effect at least as long as with Sal (8-12 hours). One might be concerned about the possible summative adverse effects of repeated Form inhalation treatment in the early stages of treatment of AAE. However, from what I can tell, there has been no more tachycardia/arrythmia or stimulatory effects (tremors, agitation) of Form than seen with albuterol inhalations administered at the same frequency.
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