Bonjour, Voici un extrait du drugdex fenoterol vs salbutamol. Vérifiez les dosages des deux solutions. Il y a plusieurs années on a tenté de nous proposer une substitution en cc pour cc, pour des produits de concentration bien différentes. Mais il faut vraiment vérifier le calcul pour les mcg.
Selon lexi-drugs: Berotec: Solution for inhalation, as hydrobromide: 0.625 mg/mL (2 mL); 0.25 mg/mL (2 mL) Ventolin: Solution for nebulization: 0.042% (3 mL); 0.083% (3 mL); 0.5% (0.5 mL, 20 mL) Dominic Larose 4.6.A.1 Asthma a) SUMMARY: Limited data suggests both fenoterol and albuterol produce similar bronchodilatation in asthmatic patients. Fenoterol by inhalation in doses of 200 to 400 mcg has been demonstrated comparable to albuterol inhalation therapy (200 to 400 mcg) in controlled clinical trials, which include comparative single-dose and dose-response trials (Manicatide et al, 1973; McLeod & Selman, 1973; Graff-Lonnevig, 1976; Minette, 1971; Riedel-Dibbern & Leblanc, 1971; Hey & Gillies, 1985; Konig et al, 1985; Maesen et al, 1984; Newhouse et al, 1994). b) The comparable efficacy of inhaled fenoterol 400 mcg, albuterol 400 mcg, and terbutaline 500 mcg was demonstrated in 63 asthmatic patients (Manicatide et al, 1973). The maximum increase in forced expiratory volume in 1 second (FEV-1) occurred within 60 minutes with all 3 drugs and was 33%, 28%, and 30% for fenoterol, albuterol, and terbutaline, respectively. A 20% increase in (FEV-1) was maintained for 4.5 hours with fenoterol as compared to 3.0 and 3.3 hours for albuterol and terbutaline, respectively. The authors concluded that fenoterol produced a slightly higher degree of bronchodilation (although the comparative increase in (FEV-1) was not statistically significant) and a slightly more prolonged duration of action in comparison to albuterol and terbutaline. Equipotent doses of fenoterol and terbutaline were not compared. No adverse effects were reported during the clinical trials. c) The bronchodilation properties of fenoterol and albuterol were compared in 15 bronchial asthmatics and 5 chronic bronchitis patients. Following a one-time inhalation dose of 400 mcg for each drug, the average percent maximum increase in expiratory flow rate was 60% following fenoterol and 30% for albuterol. Peak effect was observed at 60 to 180 minutes for fenoterol and 180 minutes for albuterol, with a duration of action of 420 minutes for fenoterol and 240 minutes for albuterol. No significant improvement in respiratory parameters was noted from either drug in the 5 patients with chronic bronchitis (Todisco et al, 1975). d) In a double-blind, cross-over study involving 38 asthmatic children, single doses (1 to 2 mg inhaled) of either albuterol or fenoterol, the response to both drugs was similar with respect to time course and magnitude (Blackhall et al, 1976). An increase in forced expiratory volume in one second (FEV-1) was observed and forced vital capacity (FVC) for both drugs was significantly increased as compared to placebo. Increased pulse rate was also observed for both drugs. e) In a comparison of 5-mg doses of fenoterol and albuterol delivered via nebulizer over 20 minutes in 10 stable adult asthmatics, forced expiratory volume in one second (FEV-1) and forced vital capacity (FVC) were measured over 8 hours. Fenoterol resulted in greater improvement in FEV-1 at each measurement, although FEV-1 had returned to baseline values by 5 hours for both. The incidence of side effects was higher with fenoterol (3 patients) versus albuterol (1 patient) (Hockley & Johnson, 1983). f) A comparative evaluation of the bronchodilator and cardiovascular effects of cumulative doses of fenoterol and albuterol aerosols was carried out in an open cross-over study in 15 patients with chronic stable reversible airway obstruction (Tandon, 1980). The bronchodilator efficacy of 480 mcg, 800 mcg and 1120 mcg of fenoterol were compared with that of 500 mcg, 900 mcg and 1100 mcg of albuterol, respectively, by analyzing the differences in percentage improvement on FEV-1. There were no significant differences in the percentage of improvement between the 2 drugs. Ventricular dysrrhythmias requiring discontinuation of the drug occurred in 2 patients receiving fenoterol 1120 mcg, in 1 patient receiving 1440 mcg and in 1 patient receiving fenoterol 1760 mcg. After 1300 mcg of albuterol, no significant ventricular dysrhythmias were observed. Thirteen patients given fenoterol complained of one or more side effects such as tremor, palpitations, headaches and sweating while only 5 did so after administration of albuterol. g) Inhalations of albuterol 180 mcg and fenoterol 320 mcg were compared in a single-dose study on three different days in 24 adult asthmatic patients. Bronchodilation forced expiratory volume in one second (FEV-1) was reportedly greater than that observed with placebo for both albuterol and fenoterol. Peak bronchodilation with both agents occurred at approximately one hour, with approximately 90% of the effect achieved in 15 minutes; bronchodilation (FEV-1) induced by fenoterol was significantly greater than albuterol only at 15 minutes and 4 hours post-inhalation. However, fenoterol had a longer duration of action than albuterol (5 hours versus 2). Side effects (primarily tremor, headache, dizziness) occurred with fenoterol but not with albuterol (Konig et al, 1985). This study suggests that fenoterol has a longer duration of action than albuterol, but produces more side effects at the doses studied. h) Albuterol and fenoterol were similar in bronchodilator effectiveness and duration of action in 12 children with asthma, aged 5 to 12 years. This randomized, double-blind, placebo-controlled trial utilized oral fenoterol elixir in a dose of 0.1 mg/kg, albuterol syrup in a dose of 0.08 mg/kg, or placebo. Pulmonary function tests at baseline and following administration of the 3 medications indicated no significant difference between fenoterol and albuterol in percentage change of forced expiratory volume in 1 second (FEV-1). However, both active treatments were superior to placebo and produced bronchodilator effects for a full 6 hours (Van Asperen & Manglick, 1986). i) The combination of fenoterol (0.1 mg/puff) and ipratropium (0.4 mg/puff) (Duovent(R)) was reported superior to albuterol (0.1 mg/puff) in patients with asthma or chronic bronchitis in a controlled study (Stewart, 1987; Crane & Gamble, 1986). With administration of 2, 4, and 6 metered doses, increases in FEV-1 were greater with Duovent(R) at all doses when compared to albuterol. These effects were achieved without an increase in side effects (tremor, pulse rate). In addition, the duration of action of Duovent(R) was longer than that of albuterol when 4 and 6 metered doses were compared. Duovent(R) may benefit a wider spectrum of patients with obstructive airway disease from various etiologies as compared to albuterol alone. In contrast, no differences were found between the two treatments in two 1-month trials in 17 patients with nocturnal asthma (Wolstenholme & Shettar, 1989). j) Dry powder drug delivery system comparisons in 40 asthmatic children showed 400 mcg albuterol is marginally more effective than 200 mcg fenoterol (Dawson et al, 1985). -----Message d'origine----- De : [email protected] [mailto:[EMAIL PROTECTED] De la part de Charles Brault Envoyé : 5 octobre 2007 02:44 À : [email protected] Objet : URG-L: Berotec Inhalation Solution Je me retouve avec : Berotec Inhalation Solution (fenoterol inhalation solution) Est-il raisonnable que son efficacité est comparable au Salbutamol ? Pourquoi prèrerait-on l'un plutôt que l'autre ? Des expérences ? Des opinions ? Incapable de trouver une réponse claire sut le Net Charles --- URG-L Pour quitter URG-L, envoyez un message a la liste ([email protected]) avec, COMME SUJET, le mot REMOVE (rien d'autre). --- URG-L Pour quitter URG-L, envoyez un message a la liste ([email protected]) avec, COMME SUJET, le mot REMOVE (rien d'autre).
