Inhaled Albuterol and Oral Prednisone Therapy in Hospitalized Adult Asthmatics

Inhaled Albuterol and Oral Prednisone Therapy in Hospitalized Adult AsthmaticsAsthma is a major cause of emergency hospitalizations in the United States, accounting for over 450,000 admissions annually in recent years with an average hospital stay of 4.8 days in 1987. Despite little evidence of efficacy, intravenous aminophylline is routinely added to beta agonist and glucocorticoid therapy in the management of hospitalized asthmatic patients, and texts continue to recommend its use. Although hundreds of papers have been published regarding theophylline pharmacokinetics and proper monitoring of serum concentrations, cases of life-threatening toxicity and death continue to be reported. Therapy with this agent is also costly, especially monitoring serum theophylline concentrations.
Aminophylline therapy has not been shown to add benefit to intensive inhaled beta agonist in the emergency room management of adult asthma, and its use in this setting is now discouraged. Systemic glucocorticoid therapy has been demonstrated to be of value in acute asthma exacerbations in adults, and is routinely used in emergency room and hospitalized patients. To our knowledge, there are no comparative studies which demonstrate the effectiveness of aminophylline therapy when it is added to inhaled beta agonists and systemic glucocorticoids in hospitalized adult asthmatics. Therefore, we conducted a randomized, double-blind, placebo controlled study to determine if aminophylline adds any benefit to inhaled albuterol and oral prednisone therapy in hospitalized adult asthmatics. Assessment of any benefits were based primarily on serial spirometry, subjective patient rating, and duration of hospitalization.

This entry was posted in Asthma and tagged , , , .