Abstract |
A 6-month prospective study was performed to examine the efficacy and safety of a rapid-sequence nebulized metaproterenol regimen for the treatment of acute asthma in adults. Patients 18 years of age or older who were not pregnant and who had not received beta 2-agonist therapy were identified and started on a rapid-sequence metaproterenol regimen (15 mg) by the triage nurse. Pretreatment and posttreatment peak flow, respiratory rate, pulse rate, and blood pressure were documented. Patients also gave a pretreatment and posttreatment rating of the clinical severity of their attack using a 1-to-10 visual analogue scale. Fifty patients were entered into the study, with an average age of 38 years (range, 19 to 87 years). Data were analyzed using the Wilcoxon matched-pairs signed rank test. Patients showed statistically significant increases in peak flow (193 to 328 L/min, P < .00001) and systolic blood pressure (136 to 143 mm Hg, P < .0054). Statistically significant decreases were shown for respiratory rate (25 to 22 beats/min, P < .0001) and clinical severity (6.2 to 3.2, P < .00001). Thirty-three patients (71%) who completed the protocol experienced an increase in pulse rate. Ten (21%) had a pulse rate increase of more than 30 beats/min. Two (4.2%) had pulse rate increases of more than 40 beats/min. Four patients were removed after one or two nebulizers because of severe side effects. One patient's pulse rate increased to more than 200 beats/min. Although effective in reversing bronchospasm, the side effects of metaproterenol when used in rapid sequence are of major concern.
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Authors | D A Jerrard, J Olshaker, E Welebob, V Caraballo, F Hooper |
Journal | The American journal of emergency medicine
(Am J Emerg Med)
Vol. 13
Issue 4
Pg. 392-5
(Jul 1995)
ISSN: 0735-6757 [Print] United States |
PMID | 7605520
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Asthma
(drug therapy, physiopathology)
- Blood Pressure
(drug effects)
- Dyspnea
(drug therapy, physiopathology)
- Female
- Humans
- Male
- Metaproterenol
(administration & dosage, adverse effects, therapeutic use)
- Middle Aged
- Nebulizers and Vaporizers
- Peak Expiratory Flow Rate
(drug effects)
- Prospective Studies
- Pulse
(drug effects)
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