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Nonprescription Inhaler More Effective for Asthma Than Previously Thought

 

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NEW YORK (Reuters Health) Jan 06 - In a small study of patients with nocturnal

asthma, a

nonprescription epinephrine inhaler was nearly as effective as a prescription

albuterol

inhaler in terminating acute airway obstruction.

 

It is widely believed that nonprescription epinephrine inhalers are less

effective and have

more adverse cardiac effects than prescription beta2-agonists, lead author Dr.

Leslie

Hendeles, from the University of Florida at Gainesville, and colleagues write.

The new

findings, however, suggest that the agents can provide similar benefits,

although more

actuations of the epinephrine inhaler are needed.

 

The findings, reported in the Annals of Allergy, Asthma, and Immunology for

December,

are based on a crossover study of eight adults with nocturnal asthma. During

nighttime

asthma flare-ups, the subjects were instructed to administer up to 14 cumulative

actuations of the assigned agent.

 

Treatment with the epinephrine and albuterol inhalers increased the FEV1 from

about 45%

to 86% and 93%, respectively. Symptoms fell as FEV1 increased and did not return

following treatment with either agent.

 

Typically, 14 cumulative actuations of the epinephrine inhaler were needed to

become

symptom free, whereas just 6 actuations of the albuterol inhaler were required.

Contrary

to concerns, the added actuations with epinephrine did not translate into an

increase in

cardiovascular effects.

 

Despite these encouraging results, " a study with a larger number of patients is

required

before epinephrine can be recommended as rescue therapy when a prescription

beta2-

agonist metered-dose inhaler is not accessible, " the authors conclude.

 

Ann Allergy Asthma Immunol 2006;95:530-534.