83062
document
Treatment of acute asthma . Lack of therapeutic benefit and increase of the toxicity from aminophylline given in addition to high doses of salbutamol delivered by metered-dose inhaler with a spacer . We conducted a randomized , double-blind , placebo-controlled study to determine if intravenous aminophylline adds any benefit to high doses of inhaled salbutamol in patients who presented for treatment of acute asthma . We studied 94 patients ( mean age , 35.6 +/- 11.2 years ) with moderate to severe acute asthma . All patients received therapy with salbutamol delivered with metered-dose inhaler ( MDI ) into a spacer device ( Volumatic ) in four puffs ( 400 micrograms ) at 10-min interval , and intravenous hydrocortisone ( 500 mg ) . Patients were randomly assigned to receive either a loading dose of intravenous aminophylline followed by a routine infusion ( n = 45 ) or an equal volume of placebo as a loading dose and infusion ( n = 49 ) . The two groups showed no differences in measurements of peak expiratory flow , FEV1 , and FVC at baseline and at the end of treatment . However , the patients treated with aminophylline had significantly more adverse effects ( p < 0.05 ) . There were no differences in the final mean dose of salbutamol ( 6.3 +/- 44.5 mg for the placebo group and 5.8 +/- 4.2 mg for the aminophylline group ) , hospital admission rate ( 10.2 percent for the placebo group and 9.0 percent for the aminophylline group ) , and mean duration of Emergency Department treatment ( 2.5 +/- 1.83 h for the placebo group and 2.37 +/- 1.75 h for the aminophylline group ) . The results were similar when the patients were divided in accord with the degree of respiratory obstruction ( baseline FEV1 < 30 percent of predicted ) and theophylline level at 30 min of treatment ( placebo group patients with theophylline level < 10 mg/L vs aminophylline group patients with theophylline level > or = 10 mg/L ) . We conclude that intravenous aminophylline adds to the toxicity but not the efficacy of inhaled salbutamol in the treatment of acute exacerbations of asthma .
83063
Intervention_Pharmacological
aminophylline
83064
Intervention_Pharmacological
salbutamol
83065
Intervention_Control
placebo-controlled
83066
Intervention_Pharmacological
aminophylline
83067
Intervention_Pharmacological
salbutamol
83068
Intervention_Pharmacological
salbutamol
83069
Intervention_Physical
metered-dose inhaler ( MDI ) into a spacer device
83070
Intervention_Pharmacological
intravenous hydrocortisone
83071
Intervention_Pharmacological
aminophylline
83072
Intervention_Control
placebo
83073
Intervention_Pharmacological
aminophylline
83074
Intervention_Control
placebo
83075
Intervention_Pharmacological
aminophylline
83076
Intervention_Control
placebo
83077
Intervention_Pharmacological
aminophylline
83078
Intervention_Pharmacological
theophylline
83079
Intervention_Pharmacological
theophylline
83080
Intervention_Pharmacological
aminophylline
83081
Intervention_Pharmacological
salbutamol
83082
Outcome_Physical
therapeutic benefit
83083
Outcome_Adverse-effects
increase of the toxicity
83084
Outcome_Physical
peak expiratory flow
83085
Outcome_Physical
FEV1
83086
Outcome_Physical
FVC
83087
Outcome_Adverse-effects
adverse effects
83088
Outcome_Physical
respiratory obstruction
83089
Outcome_Physical
theophylline level
83090
Outcome_Adverse-effects
toxicity
83091
Outcome_Other
efficacy
83092
Participant_Condition
acute asthma
83093
Participant_Sample-size
94
83094
Participant_Condition
moderate to severe acute asthma