PHAR 200 Study Guide - Midterm Guide: Salbutamol, Racemic Mixture, Nebulizer
Document Summary
These drugs are useful for treatment of asthma in patients who are poorly controlled by conventional therapy. These drugs should be used in conjunction with ics therapy for most patients, not as monotherapy. Two randomized controlled trials compared racemic albuterol to levalbuterol. Nowak and colleagues102 enrolled 627 adults with acute asthma exacerbations presenting to the emergency department or to acute care clinics. Approximately two-thirds of these patients were african american. Nebulized treatments of either levalbuterol 1. 25 mg or racemic albuterol 2. 5 mg were given every 20 minutes for 1 hour, then every 40 minutes for 3 additional doses, then as necessary for up to 24 hours. The time to meet emergency department or clinic discharge criteria (the primary outcome) did not differ between the 2 treatments: 76. 0 minutes with levalbuterol and 78. 5 minutes with albuterol (p=0. 74). Hospitalization rates were similar between groups (levalbuterol 7. 0% and albuterol 9. 3%, p=0. 28).
