Résumé
Thirty acute asthmatic patients (mean age 35.6 +/- 13.5 years, mean FEV1 0.97 +/- 0.95 L) in the emergency room were evaluated for airway response to procaterol administered by metered-dose inhaler (MDI) compared to MDI with auxiliary device (a paper spacer) in a randomised cross over study. Bronchodilator response to procaterol delivered by MDI, with paper spacer was significantly greater than that by MDI without spacer (mean maximal increment of FEV1, 0.67 +/- 0.46 vs 0.59 +/- 0.46 L, p = 0.016, mean maximal increment of PEFR, 112 +/- 62.3 vs 86.7 +/- 61.3 L/min, p = 0.003) but there was no difference in dyspnoea score, wheezing score and heart rate. This collapsible and portable auxiliary device (paper spacer) can increase therapeutic efficacy of bronchodilator response in asthmatic patients.
Sujets)
Maladie aigüe , Adolescent , Adulte , Asthme/traitement médicamenteux , Bronchodilatateurs/administration et posologie , Études croisées , Relation dose-effet des médicaments , Conception d'appareillage , Femelle , Volume expiratoire maximal par seconde , Humains , Mâle , Adulte d'âge moyen , Nébuliseurs et vaporisateurs , Procatérol/administration et posologie , Résultat thérapeutiqueRésumé
Objective of the study: To determine the maximal bronchodilator dose of procaterol and pirbuterol administered by inhalation with an without an aerochamber (Aerocâmera) to children with acute brinchial asthma attacks. Type of study: Prospective. 18 children (6-15 years of age) with acute bronchial asthma attacks (FEV1 < 80 per cents of the predicted value) received pirbuterol (N = 10) or procaterol (N = 8) by metered-dose inhaler, one puff every 5 minutes, for a total of five doses. During another acute attack, the same patient received the same medication with the aid of a spacer (Aerocâmera). Clinical evaluation and pulmonary function tests were performed 5 minutes after each inhaled dose. Results: For both drugs, maximal bronchodilation was obtained after the second dose. No significant side effects were observed even after procaterol doses of 50 µg or pirbuterol doses of 1000 µg. The results were unaffected by the use of the spacer. Conclusions: The doses that induced maximal bronchodilation were 400 µg pirbuterol and 20 µg procaterol Although the spacer did not change the results, it is a valuable aid for patients who have difficulty in using the metered-dose inhaler (M.D.I.)