Comparison of Outpatient Nebulized vs Metered Dose Inhaler Terbutaline in Chronic Airflow Obstruction: Patient Assessments

Patient Assessments
Spiwmetry: Patients were assessed at the same time of day on four occasions. Beta-agonists were omitted for six hours prior to testing. The FEV, and VC were measured on a Vitalograph spirometer using the best of three measurements. In the acute response studies, assessments were made on consecutive days when baseline spirometry differed by less than 10 percent. Cumulative unit doses of terbutaline and placebo MDI and NEB were given and spirometty was recorded 10 min after each dose until FEV, plateaued. Baseline spirometry was assessed at the end of each treatment fortnight during the outpatient study. lumigan eye drops

Six minute walking distance: Paired 6MWD (separated by 20 min) were performed in a covered hospital corridor according to the method of McGavin et al. The acute response studies were performed pHor to administration of bronchodilators and after maximum bronchodilatation. Baseline walks were made at the end of each treatment fortnight during the domiciliary study. Symptom shores and extra beta-agonist use: Daily diary cards of symptom scores were kept during the domiciliary study. Scores from 0 to 3 were entered for cough, wheeze, sputum production, exertional athlessness and sleep disturbance. Extra beta-agonist use was also recorded. Subjective patient preference: At the completion of the outpatient study, patients were asked to express their preference for the first or second treatment period.
Analysis of Results
Analysis of all data was performed using the Wilcoxon signed rank sum test and the paired Student t test.
Results
Patient Characteristics
Nineteen patients were enrolled in the study. One patient withdrew because of an acute infective exacerbation of his disease. The details of the 18 patients who completed the study are shown in Table 1. Seventeen patients were men. The mean age was 67.5 years (range 62-75 years). Fourteen patients were exsmokers, three still smoked, and one was a nonsmoker. There were nine asthmatic patients. It is notable that five of the patients who had a less than 15 percent increase in FEVj after therapy with 200 μg of salbutamol dembnstrated significant reversibility of airflow obstruction after one unit dose of terbutaline MDI or NEB.
Table 1—Baseline Spirometric Results, 18 Fatients

	Range	Mean±SE	Mean, % Pred
FEV.(L)	0.52-2.20	1.02 ±0.10	34.70
VC (L)	1.60-4.90	3.30±0.24	87.40
FEV,/VC%	15-54	32 ±2.8	–

Category: Airflow Obstruction

Tags: airflow obstruction, bronchodilator, lung, terbutaline