Oral Therapy with Fenoterol Hydrobromide and Ephedrine Comparison Outcomes

Analysis of the sequential data on pulmonary function that were obtained after administration of each testing dose revealed that the FEVi and Gaw/ Vl provided the most reliable and consistent measurements. Although improvement in the FEVi following administration of isoproterenol was used as the criterion for inclusion in this study, the most discriminating changes occurred in the measurements of Gaw/Vb. The other measurements of pulmonary function showed less impressive and somewhat more variable changes.

As shown in Table 2, no greater than a 25 percent improvement in FEVi occurred during the eight hours following administration of placebo. “Pharmacologic bronchodilation” therefore occurred when the FEVi improved by more than 25 percent above baseline. Using this measure, 5 mg of feno-terol hydrobromide produced bronchodilation during the interval of time from two hours to eight hours after administration. Ephedrine did not produce any greater effect than placebo, other than marginal improvement at the fourth hour after administration. The changes in FEVi are depicted in Table 2, which shows that the detectable improvement following each dose of fenoterol occurred between one and two hours after administration and persisted during the remainder of the eight hours of the study.

Fenoterol InhalerThe values for Gaw/Vb are graphically presented in Figure 2. No significant response occurred with placebo, the maximum increase being 21 percent. Each dose of fenoterol produced an increase of more than 25 percent. The 5-mg dose resulted in increases of 37 percent, 44 percent, 35 percent, and 32 percent at two, three, four, and five hours after administration, respectively, while greater increases occurred with the two higher doses of fenoterol. Ephedrine resulted in increases of 25 percent and 26 percent only at the third and fourth hour, respectively, after administration.

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Minor increases in the pulse rate were noted following therapy with both ephedrine and fenoterol, in comparison with placebo. The differences were not statistically significant. The mean maximum change was an increase in pulse rate of seven beats per minute five hours after therapy with 10 mg of fenoterol hydrobromide. No significant changes in systolic or diastolic blood pressure were noted, nor were there any changes of significance noted in the electrocardiographic tracings.

Side effects were minimal; four patients complained of nervousness after receiving fenoterol (one of whom also developed the same symptoms after receiving both ephedrine and placebo), and two patients complained of shakiness after receiving the 7.5-mg and 10-mg doses of fenoterol hydrobromide. No patient developed a headache after receiving fenoterol, but one did after receiving ephedrine. It was noteworthy that all of these adverse experiences were reported by only five of the 20 patients (Table 3). No additional reports of objective abnormalities were elicited following any of the administrations of drugs, but one patient did have an asthmatic attack (find more information about it – https://onlineasthmainhalers.com/category/asthma) after receiving the placebo. In general, patients were unable to differentiate between the placebo and the other medications.

Both the 7.5-mg and 10-mg doses of fenoterol hydrobromide produced a statistically significant (P < 0.05) greater mean increase in Gaw/Vb than the mean changes noted with placebo. This findingis based on Dunett’s procedure; using the less conservative standard paired f-test, a significance of P < 0.005 was calculated Although the response to the 7.5-mg dose of fenoterol hydrobromide was often slighdy higher than the response to the 10-mg dose, it was not statistically significant. Comparison of the square roots of the areas under the true curves indicated the Gaw/Vb to be greater after the 10-mg dose than after the 7.5-mg dose.

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airway conductance

 

Figure 2. Mean specific airway conductance (Gaw/Vb) vs time in 20 patients.

Table 2—Mean Value SD) for FEV\ and Percent Changes from Baseline Value in 20 Patients

Mean FEVi, ml (Percent Change from Baseline)A
t Fenoterol Hydrobromide Ephedrine (24.0 mg)
Time Placebo 5 mg 7.5 mg 10 mg
Baseline 15 min 30 nSin1    hr2    hr3    hr4    hr5    hr6    hr 8 hr 922.5    ±411.6 (…)964.5    ± 458.1 (4.6) 1,003.5 ±510.0 (8.8)1.071.1    ±500.3 (16.1) 1,109.5±499.3 (20.3) 1,117.5±531.3 (21.1) 1,108.5± 502.8 (20.2) 1,145.4± 503.6 (24.2) 1,093.3 ± 460.4 (18.5)1.082.1    ±484.3 (17.3) 925.0 ± 385.9 (…)1.050.5    ±461.2 (13.6) 1,049.2 ±460.7 (13.4)1.132.5    ±490.3 (22.4)1.216.0    ± 542.1 (31.5) 1,265.0±537.6 (36.8)1.240.5    ± 548.4 (34.1)1.243.0    ± 552.3 (34.4) 1,176.0±551.3 (27.1) 1,158.0± 539.7 (25.2) 930.8 ± 392.4 (…)1.020.0    ±460.1 (9.6) 1,140.0±519.8 (22.4)1.285.5    ± 565.7 (38.1*)1.398.0    ± 572.4 (50.2*) 1,413.0±575.0 (51.8*)1.386.5    ± 499.3 (49.0*)1.329.0    ± 481.4 (42.8)1.307.5    ± 505.1 (40.5*)1.242.5    ± 504.1 (33.5) 995.8± 408.4 (…)1.065.0    ±499.7 (6.9)1.210.1    ±532.1 (21.5)1.332.0    ± 541.1 (33.8*)1.420.0    ± 584.5 (42.6*)1.439.0    ±558.7 (44.5*)1.420.5    ± 536.0 (42.6*)1.304.5    ±501.4 (31.0) 1,321.0±493.5 (32.7)

1.247.0    ± 492.0 (25.2)

1,008.8 ±406.5 (…)1.085.0    ±470.5 (7.6)1.113.0    ±493.0 (10.3) 1,158.5± 496.8 (14.8)1.217.5    ± 508.9 (20.7) 1,197.5±492.8 (18.7)1.276.5    ±547.8 (26.5) 1,197.5±492.2 (18.7)1.133.5    ±477.6 (12.6)1.126.5    ± 499.9 (11.7)

Table 3—Side Effect of Administration of Fenoterol, Ephedrine, and Placebo

Treatment, Dose Side Effects Patient
Placebo Nervousness 201
Asthma 214
Ephedrine, 24.0 mg Nervousness 201
Headache 211
Fenoterol hydrobromide, 5 mg Nervousness 202
Nervousness 210
Fenoterol hydrobromide, 7.5 mg Nervousness 202
NervousnessNervousness; 204
ahftlrinftaa 210
Fenoterol hydrobromide, 10 mg Nervousness 201
Nervousness 202
Nervousness 204
Shakiness 209
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