Yafteh

1. Assistant professor, Department of internal, Faculty of medicine, Hamedan University of medical sciences

2. Associate professor, Department of internal, Faculty of medicine, Hamedan University of medical sciences

3. Associate professor, Department of Pharmacology, Faculty of medicine, Hamedan University of medical sciences

4. Instructor, Department of social medicine, Faculty of medicine, Hamedan University of medical sciences

5. General practitioner, Tuberculosis and lung research group, Faculty of medicine, Hamedan University of medical sciences

Abstract

Background: Asthma is an inflammatory and chronic disorder of trachobronchial tree that is associated with increased response to allergens. Treatment of acute attack of asthma is short acting b 2 agonist such as Albuterol that is used via a nebulizer or Metered-dose inhaler (MDI) with and attached spacer. Object of this study was evaluation of therapeutic effects of Albuterol via a nebulizer or MDI with an attached holding chamber in patients that had been referred to Emergency departement of Mobasher Hospital in Hamadan.

Materials and methods: The present study was a clinical trial (before and after) in 60 patients that were suffered from acute attack asthma. Inclusion criterias were 16-65 years old age patients, FEV1, below 60% of predicted value, and cooperation for spirometry performance. Exclusion criterias were COPD, cardiovascular disorders, pneumonia, preumothorex, or their systemic or pulmonary disorders,severe respiratory failure with cyanosis or confusion, pregnancy and smoking. On arrival to the ED, all patients underwent spirometery and all of patients received oxygen and a single dose of 8 mg intravenous dexamethasone. Immediately thereafter patients were randomized to two groups.The study was designed as double blind trial. The first group patients received four puffs Albuterol attached to spacer and immediately distilled water via nebulizer. The second group patientts received 5 mg Albuterol solution via nebulizer after administration of placebo inhaler attached to holding chamber. All of the patients received a total of four treatment. The first dose was administered immediately after spirometry and then every 30 minutes. Spirometry was performed at entry between to the study and then 15 minutes after each treatment.

Results: Analysis of comparison of bronchodilating effects of salbutamol via nebulizer or MDI with attached to spacer showed similar effects in two methods (P>0.05). FEV1, FVC, FEV1/FVC changes were significant among four treatments in every group (P<0.05) but there was no difference between two methods among four treatments (P<0.05).

Conclusion: A short acting b 2-agonist such as Albuterol can be administer in patients with acute attack asthma with every two methods (nebulizer or MDI with attached spacer) and have similar bronchodilating effect.