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Despite major improvements in drug output of new nebulizers and differences between nebulizers [1], doses of albuterol nebulizing therapy of hospitalized COPD-patients has not changed in the last decades. The objective was to determine the optimal dose in the current setting according to a standardized protocol (10 min at flow 8 l min−1, MICRO MIST nebulizer, Hudson RCI). After a washout of bronchodilators patients nebulized 5 mg (group A; n=21. FEV1=47.4 ± 2.9% predicted; Tiffeneau=48.1 ± 2.5%) or 10 mg (group B; n=21, FEV1=50.5 ± 3.8% predicted; Tiffeneau=49.5 ± 3.4%) albuterol (t=−10 to 0 min). Pulmonary function (PF) (FEV1, FVC, Tiffeneau), dyspnoea (modified Borg scale) and heart-frequency (HF), blood pressure (BP), breathing-frequency (BF), serum potassium (K), fingertremor, QTc-interval, were measured at t=−30, 10, 30, 60, 120, 240 min. Charcoal was administered to prevent gastrointestinal absorption (t=−10; 10 min (5 g) and 60 min (10 g). Pharmacodynamic (PD)-effects, relative to baseline, and correlation between effects, severeness of COPD and patient characteristics were analysed. FEV1 and FVC increased significantly (FEV1: (A) 10–120 min; (B) 10–240 min; Figure 1), leaving Tiffeneau unchanged. FVC at t=10 is significantly greater for group B compared to A (P=0.009). PD-parameters (Table 1) showed significant changes. Figure Figure 1 . Mean FEV1, FVC in groups A and B. lu FEV, A, su FEV, B, uu FVCA, au FVCB. Download figure to PowerPoint Table 1. PD-parameter differences relative to t=−30 min, group A and B t=10 t=30 t=60 t=120 t=240 * Significant within group; ^ significant between groups; P |
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