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Inhaled Epinephrine and Oral Theophylline—Ephedrine in the Treatment of Asthma
Author(s) -
Pinnas Jacob L.,
Schachtel Bernard P.,
Chen Tien Min,
Roseberry H. Randall,
Thoden William R.
Publication year - 1991
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/j.1552-4604.1991.tb04969.x
Subject(s) - epinephrine , medicine , theophylline , placebo , ephedrine , anesthesia , asthma , bronchodilator , alternative medicine , pathology
Inhaled and oral over‐the‐counter bronchodilators are used for self‐therapy by asthmatic patients. To evaluate their safety and efficacy, we compared epinephrine and theophylline combined with ephedrine with inhaled metaproterenol and the placebo. Twelve asthmatic patients were studied in a randomized, double‐blind, placebo‐controlled, crossover trial comparing forced expiratory volume in 1 second (FEV 1 ) after two inhalations of epinephrine (0.2 mg/inh), 1 minute apart, followed in 15 minutes by theophylline (130 mg) with ephedrine (24 mg) versus two inhalations of metaproterenol (0.65 mg/inh), 1 minute apart, versus placebo inhaler and tablets. Onset of FEV 1 > 15% above baseline values occurred within 15 seconds after inhalations for 100% of epinephrine‐treated patients, 92% of metaproterenol‐treated patients, and 33% of placebo‐treated patients. FEV 1 responses were significantly greater (P < .05) for epinephrine at 0.66 to 1.66 minutes compared with the responses of metaproterenol, and epinephrine and theophylline that was combined with ephedrine compared with metaproterenol beginning at 2 hours. Mean duration of activity was 5.7 hours for the epinephrine‐ and theophylline with ephedrine‐treated patients, 4.9 hours for metaproterenol‐treated patients, and 2 hours for the placebo group. There were statistically significant differences for patients receiving epinephrine and theophylline with ephedrine versus the placebo group (P < .001), metaproterenol patients versus the placebo group (P = .02), and patients receiving epinephrine and theophylline with ephedrine versus metaproterenol‐treated patients (P < .05). Compared with inhaled metaproterenol, inhaled epinephrine followed in 15 minutes by a theophylline—ephedrine tablet had a significantly earlier onset, longer duration of action, numerically greater peak effect, and patient preference. This combination of oral and inhaled bronchodilator medication is as safe and effective as inhaled metaproterenol.