Vollmer M, Schmidt E W, Ulmer W T
Berufsgenossenschaftliche Kliniken Bergmannsheil, Abteilung für Pneumologie und Allergologie.
Pneumologie. 1995 Oct;49(10):528-34.
Duration and intensity of bronchodilator action of 0.2 mg Fenoterol, 0.2 mg Salbutamol, and 0.05 mg Salmeterol were investigated in 15 subjects with COPD over a period of 12 hours. Airway resistance and FEV1 were measured and subjective side effects noted. Salbutamol MDI was used as rescue medication. Airway resistance and FEV1 demonstrated significant bronchodilation with all bronchodilator drugs after 15 min and maximum bronchodilation between 1 and 2 hrs. After 3 to 5 hrs. bronchodilator effects of fenoterol and salbutamol are lost by at least 50%, whereas this effect is only seen after 8 to 9.5 hrs. with salmeterol. There were considerable individual differences of the efficacy of all three drugs. However, salmeterol was equally efficaceous, compared to fenoterol and salbutamol, but its duration was at least twice as long. Consequently, rescue medication was used in only about 50% of the cases. Side effects of all substances were comparable. From these data it may be concluded that the efficacy of beta2-adrenergic agonists is comparable, irrespective of the duration of action of a single administration, if repeated administrations are used with short acting substances. In addition, this study confirmed that in individual patients a) the response to beta2-adrenergic agonists is variable and b) that different lung function parameters such as airway resistance and FEV1 may give different results.
对15名慢性阻塞性肺疾病(COPD)患者,研究了0.2毫克非诺特罗、0.2毫克沙丁胺醇和0.05毫克沙美特罗在12小时内的支气管扩张作用持续时间和强度。测量气道阻力和第1秒用力呼气容积(FEV1),并记录主观副作用。使用沙丁胺醇定量气雾剂作为急救药物。15分钟后,所有支气管扩张药物均使气道阻力和FEV1出现显著支气管扩张,1至2小时达到最大扩张。3至5小时后,非诺特罗和沙丁胺醇的支气管扩张作用至少丧失50%,而沙美特罗在8至9.5小时后才出现这种情况。三种药物的疗效存在相当大的个体差异。然而,与非诺特罗和沙丁胺醇相比,沙美特罗的疗效相同,但其作用持续时间至少是它们的两倍。因此,只有约50%的病例使用了急救药物。所有药物的副作用相当。从这些数据可以得出结论,如果对短效物质进行重复给药,β2肾上腺素能激动剂的疗效是相当的,而与单次给药的作用持续时间无关。此外,本研究证实,在个体患者中,a)对β2肾上腺素能激动剂的反应是可变的,b)不同的肺功能参数,如气道阻力和FEV1,可能会给出不同的结果。