Scalabrin D M, Solé D, Naspitz C K
Department of Pediatrics Universidade Federal de São Paulo São Paulo, Brazil.
J Asthma. 1996;33(6):407-15. doi: 10.3109/02770909609068185.
Thirty-seven separate episodes of acute bronchial asthma were studied in 21 asthmatic children. The bronchodilator, cardiovascular, and tremorigenic responses following administration of salbutamol (SAL), terbutaline (TER) and fenoterol (FEN) by closed-port intermittent nebulization were compared for a period of 8 hr. SAL was used at the maximum dose recommended by the manufacturer and TER and FEN at the average doses commonly used in children. Eleven acute attacks were treated with SAL, 12 with TER, and 14 with FEN. Pulmonary function was evaluated by clinical assessment and by the spirometric indices FEV1 and FEF25-75. Tremor was objectively measured, as well as heart rate (HR), respiratory rate, and blood pressure. The onset of bronchodilating effect occurred at 5 min for all three drugs and there were no differences in intensity and duration of bronchodilation between drugs. All three drugs caused rapid onset of tremor (5 min) and this tended to be more intense with SAL. There was a slight decrease in HR in the TER group, whereas SAL and FEN caused increase in HR, with mean values significantly greater than in the TER group from 5 to 30 min after drug administration. Our results indicate that the three short-acting beta 2-agonists studied are equally effective in treatment of acute bronchospasm by the inhaled route in children, in the doses used. Our findings imply that a dose of SAL twice as great as that commonly used by nebulization in children is equipotent to those usually employed for TER and FEN, as far as therapeutic effect is concerned, but it could generate more intense tremorigenic and tachycardic side effects.
对21名哮喘儿童的37次急性支气管哮喘发作进行了研究。通过密闭口间歇性雾化吸入沙丁胺醇（SAL）、特布他林（TER）和非诺特罗（FEN）后，比较了8小时内的支气管扩张、心血管和致震颤反应。SAL使用制造商推荐的最大剂量，TER和FEN使用儿童常用的平均剂量。11次急性发作采用SAL治疗，12次采用TER治疗，14次采用FEN治疗。通过临床评估以及肺量计指标第一秒用力呼气容积（FEV1）和用力呼气25%-75%肺活量时的瞬间呼气流量（FEF25-75）评估肺功能。客观测量震颤，以及心率（HR）、呼吸频率和血压。三种药物的支气管扩张作用均在5分钟时出现，药物之间支气管扩张的强度和持续时间无差异。三种药物均导致震颤迅速发作（5分钟），SAL引起的震颤往往更强烈。TER组HR略有下降，而SAL和FEN导致HR升高，给药后5至30分钟的平均值显著高于TER组。我们的结果表明，在所使用的剂量下，研究的三种短效β2激动剂通过吸入途径治疗儿童急性支气管痉挛的效果相同。我们的研究结果表明，就治疗效果而言，雾化吸入时儿童常用剂量两倍的SAL与TER和FEN通常使用的剂量等效，但可能会产生更强烈的致震颤和心动过速副作用。
