Open AccessEfficacy of Inhaled Levalbuterol Compared to Albuterol in Horses with Recurrent Airway Obstruction
Author(s) -
Arroyo M.G.,
Couëtil L.L.,
Nogradi N.,
Kamarudin M.M.,
Ivester K.M.
Publication year - 2016
Publication title -
journal of veterinary internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.356
H-Index - 103
eISSN - 1939-1676
pISSN - 0891-6640
DOI - 10.1111/jvim.14320
Subject(s) - bronchodilatation , medicine , bronchodilator , anesthesia , onset of action , asthma , crossover study , pulmonary function testing , airway obstruction , transpulmonary pressure , airway , lung , lung volumes , placebo , alternative medicine , pathology
Background The (R)‐enantiomer of racemic albuterol (levalbuterol) has bronchodilatory properties whereas the (S)‐enantiomer causes adverse effects in human airways, animal models, and isolated equine bronchi. Levalbuterol is commercially available and improves pulmonary function of asthmatic patients with a longer duration of effect than albuterol. Objective To determine the dose at which inhaled levalbuterol produces maximal bronchodilatory effect ( ED max) and determine its duration of action in recurrent airway obstruction ( RAO )‐affected horses in comparison to racemic albuterol. Animals Nine horses with inducible and reversible RAO . Methods Randomized, crossover trial. Horses were challenged with moldy hay to induce airway obstruction. Horses were treated with nebulized albuterol or levalbuterol chosen randomly. Pulmonary function testing ( PFT ) was measured before and for up to 3 hours after bronchodilatation challenge. Maximum change in transpulmonary pressure ( DP max ) was measured to assess the dose effect and duration of action of each drug. After a 24 hours washout period, the bronchodilatation challenge was repeated with the second bronchodilator. Results The duration of effect was 60 minutes for albuterol and 120 minutes for levalbuterol. The dose of bronchodilator ED max was not significantly different between albuterol and levalbuterol ( ED max = 125.0 [125–125 μg] and ED max = 188 [125–188 μg] respectively; P = .068). The magnitude of bronchodilatation was not significantly different between the 2 treatments (61.1 and 59.9% decrease in DP max for albuterol and levalbuterol respectively; P = .86). Conclusions and clinical importance Levalbuterol is as effective a bronchodilator as albuterol; although levalbuterol lasts twice as long as albuterol, its duration of action is still too short to make it practical for RAO treatment.