Am. J. Respir. Crit. Care Med., Vol 151, No. 3, Mar 1995, 602-606.
Continuous versus intermittent nebulized terbutaline: plasma levels and effects
FW Moler, CE Johnson, C Van Laanen, JM Palmisano, SZ Nasr and O Akingbola
Department of Pediatrics, College of Pharmacy, University of Michigan Medical Center, Ann Arbor.
The purpose of this investigation was to compare continuous versus
intermittent nebulization of a beta 2-agonist, terbutaline, to determine
whether differences exist in plasma concentrations or adverse
cardiovascular effects of the drug with these two techniques for its
administration. Sixteen children 6 to 16 yr of age, admitted for acute
asthma, were enrolled in this randomized double-blind clinical trial.
Nebulization of 16 mg of terbutaline over an 8-h period was performed
either continuously or intermittently, with a dose of 4 mg given over 20
min every 2 h. The peak plasma terbutaline concentration for the
intermittent nebulization treatment (INT) group (5.1 +/- 2.1 ng/ml)
occurred 1 h after the fourth inhalation treatment and was similar to the
peak concentration for the continuous nebulization treatment (CNT) group,
which was reached at the end of the 8 h period (4.7 +/- 2.3 ng/ml). The
maximum heart rate increase for the INT group (19.6 +/- 18.3 bpm) occurred
1 h after the fourth dose and was similar to the peak observed in the CNT
group (19.6 +/- 19.2 bpm), which occurred after 3 h. Similar increases in
systolic and decreases in diastolic pressures were observed for the INT and
CNT groups. No evidence of serious adverse myocardial complications was
seen in either group, as evidenced by measurements of the MB fraction of
creatine phosphokinase (CPK-MB) and Holter-monitor recordings. Continuous
nebulization of the terbutaline produces similar plasma concentrations and
cardiovascular physiologic responses as intermittent nebulization.(ABSTRACT
TRUNCATED AT 250 WORDS)
