Comparison of the acute effects of salbutamol and

terbutaline on heart rate variability in adult

asthmatic patients
ABSTRACT: This study investigated the effects of b 2-adrenergic agonist therapy on heart rate variability
(HRV) in adult asthmatic patients by using frequency domain measures of HRV.
A randomized crossover design was used. Twenty adult patients with asthma were studied. All patients showed
a mild-to-moderate decrease in baseline forced expiratory volume in one second. Any diseases that might have
influenced the autonomic function were excluded. All patients had a complete physical examination and medical
history that revealed no cardiovascular disease or medication. The study used 200 mg inhaled salbutamol and 500
mg inhaled terbutaline. HRV analysis was performed for each 5-min segment, 5 min before inhalation of the
study drug and 5, 10, 15, 20, 25 and 30 min after inhalation. Total power (TP: v0.40 Hz), high-frequency power
(HF:
0.15 – 0.40 Hz), low-frequency power (LF: 0.04 – 0.15 Hz) and LF/HF ratio were calculated.
The LF and LF/HF ratio increased and TP decreased at 5, 10, 15 and 20 min after the salbutamol and the
terbutaline inhalation, HF did not change significantly after the salbutamol and terbutaline inhalation.
Acute salbutamol and terbutaline inhalation produce similar effects on heart rate variability and increase
sympathetic modulation in the cardiac autonomic activity.
 Comparison of Terbutaline and Salbutamol
Inhalation in Children with Mild or Moderate
Acute Exacerbation of Asthma

Abstract. Objectives To compare the clinical efficacy and side effects of terbutaline and
salbutamol administered by metered dose inhaler and holding chamber in the mild to
moderate acute exacerbations of asthma in children. Methods: The study subjects
were children in the age group of 5- 15 years who presented with a mild or moderate
acute exacerbation of asthma. Baseline assessment included clinical parameters and
spirometry. The children were then randomized to receive salbutamol or terbutaline. Three
puffs each of either 100 mcg salbutamol or 250 mcg of terbutaline were administered using
750 ml holding chamber with valve. Thirty minutes after drug administration, the
children were reevaluated for clinical parameters and spirometry. Reso/Is: Of the total
60 subjects studied, 31 were administered terbutaline and 29 salbutamol. The
baseline spirometric parameters were comparable. After drug administration, all the
studied variables showed significant improvement within each group. However, there were
no statistically significant differences when the two groups were compared with each
other. There was no significant difference in the side effects between two groups.
Conclusion: Terbutaline and salbutamol, when administered by MDI with holding
chamber, are equally efficacious in children with mild or moderate acute exacerbation of
asthma

Safety of formoterol by Turbuhaler1 as

 reliever medication compared with
terbutaline in moderate asthma

ABSTRACT: The present study compared the safety of 4.5 mg formoterol with 0.5 mg terbutaline, both by
Turbuhaler1 and used as needed, in addition to regular formoterol in moderate asthma.
In this double-blind parallel-group study, 357 patients taking a moderate-to-high dose of inhaled
corticosteroids and additional terbutaline (2–5 inhalations?day-1 during run-in) were randomised to either
formoterol or terbutaline as needed in addition to formoterol 9 mg b.i.d. over 12 weeks. Adverse events,
serum potassium levels, electrocardiogram, vital signs and lung function were assessed monthly; peak
expiratory flow and severe asthma exacerbations were recorded daily.
Patients used 2.16 (range 0.0–6.3) formoterol and 2.34 (range 0.1–7.5) terbutaline relief inhalations?day-1. No
clinically significant differences in safety variables were found between treatments. Statistically greater increases
in cardiac frequency (2.6 beats?min-1, p=0.03) were found on terbutaline. There were 44 and 52 severe asthma
exacerbations with formoterol and terbutaline, respectively, with no significant difference in time to first
exacerbation. There was also no difference between treatments for other efficacy measures (peak expiratory
flow, forced expiratory volume in one second and morning/evening symptom scores).
Formoterol 4.5 mg as needed was at least as safe, well tolerated and effective as terbutaline 0.5 mg in stable
patients (requiring up to 6 relief inhalations?day-1) taking formoterol plus inhaled corticosteroids regularly over
12 weeks.