Use of salbutamol in pentamidine induced bronchospasm. A randomized placebo controlled trial.

Important note: Information in this article was accurate in 1993. The state of the art may have changed since the publication date.

Use of salbutamol in pentamidine induced bronchospasm. A randomized placebo controlled trial.

Int Conf AIDS. 1993 Jun 6-11;9(1):379 (abstract no. PO-B10-1466). Unique Identifier : AIDSLINE MED/93335015
McIvor RA; Favell K; Lee Pack LR; Chan CK; Toronto Aerosolized Pentamidine Clinic, University of Toronto, Canada.

Abstract: OBJECTIVE: To ascertain the best protective regimen to eliminate aerosol pentamidine (AP) induced bronchoconstriction at the time of administration and in the four hours following therapy. METHODS: Forty one HIV-infected individuals with significant pentamidine induced bronchospasm (PIB), mean drop in FEV, > or = 15% post AP were enroled. Each patient performed spirometry before and 15 minutes after a single 60 mg dose of AP administered via Fisoneb. Each patient then received one of 5 treatments regimens in a random order. Placebo MDI two puffs, salbutamol 200 mg via MDI, salbutamol 200 mg via MDI and aerochamber (A/C), salbutamol 400 mg via MDI and A/C, salbutamol 1.25mg nebulised and 2.5 mg salbutamol nebulised. PEFR was measured with a Wrights mini peak flow meter immediately prior to AP and each hour for 4 hours after. RESULTS: The mean decrease in FEV, after a single dose of AP was 25% (range 13-44%). All treatment regimens significantly eliminated PIB. The 1.25 mg nebulised salbutamol showed significant increased bronchodilation compared to 200 mg via MDI and was the preferred treatment rated by the patients. Although a dose response was noted a full 2.5 mg salbutamol caused significant side effects and was poorly tolerated. PEFR dropped over the 4 hours post-AP, but were normalized with salbutamol, the 1.25 mg nebulized regimen was again the most superior, without substantial improvement with 2.5mg. CONCLUSION: Administration of salbutamol prevents acute PIB, nebulized salbutamol 1.25 mg 15 minutes prior to therapy also allows normalization of PEFR over the subsequent 4 hours.

Keywords: *Albuterol/THERAPEUTIC USE *AIDS-Related Opportunistic Infections/PREVENTION & CONTROL *Bronchial Spasm/CHEMICALLY INDUCED *Bronchial Spasm/DRUG THERAPY *HIV Infections/DRUG THERAPY *Pentamidine/ADVERSE EFFECTS
931130
M93B4269

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