Chest ACCP Member Benefits
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by D'Alonzo, G. E.
Right arrow Articles by Karlsson, K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by D'Alonzo, G. E.
Right arrow Articles by Karlsson, K.
(Chest. 1995;107:406-412.)
© 1995 American College of Chest Physicians

Bambuterol in the Treatment of Asthma

A Placebo-Controlled Comparison of Once-Daily Morning vs Evening Administration

Gilbert E. D'Alonzo DO, FCCP1; Michael H. Smolensky PhD1; Stuart Feldman PhD2; Yvonne Gnosspelius PhD3; and Kerstin Karlsson RN3

1 From the Schools of Medicine and Public Health, University of Texas Health Science Center at Houston, Lund, Sweden
2 From the School of Pharmacy, University of Houston, Lund, Sweden
3 From Astra Draco AB, Lund, Sweden

Once-daily morning (7 AM) vs evening (10 PM) administration of the terbutaline prodrug bambuterol (20-mg tablet dose) was investigated in a double-blind, cross-over, randomized, and placebo-controlled study involving 29 diurnally active patients with asthma. Terbuta-line plasma concentration, spirometry, and drug tolerance were assessed during 39-h inpatient studies. A 7-day washout period separated each treatment. Mean 24-h plasma concentration was comparable for morning and evening bambuterol (13.2 vs 14.0 nmol/L). The Cmax for evening vs morning dosing was 17.2 vs 15.5 nmol/L (p<0.02). The 24-h mean FEV1 was greater (p<0.001) for bambuterol (morning: 3.2 L; evening: 3.4 L) vs placebo (2.9 L) as it was for FVC, FEF25-75%, and peak expiratory flow rate (PEFR), with the maximum effect at 4 AM independent of medication time. Evening dosing, however, resulted in greatest 7 AM (awakening) FEV1, FEV25-75, and PEFR (p<0.03). With reference to corresponding-in-time placebo values, improvement in FEV1 at the end of the 24-h dosing intervals amounted to 0.34 L (13.5%) (p<0.0004) and 0.35 L (15.9%) (p<0.0012) with evening and morning bambuterol dosing, respectively. Side effects were greater for bambuterol than placebo, but not significantly so. Once-daily bambuterol therapy proved to be an effective treatment for asthma, whether administered in the evening or morning. Evening dosing seems best for nocturnal asthma since airway patency overnight and on awakening at 7 AM is most improved.

Key Words: asthma • bambuterol • pharmacokinetics • side effects • spirometry

Submitted on December 6, 1993
Accepted on June 10, 1994




This article has been cited by other articles:


Home page
 Am. J. Respir. Crit. Care Med.Home page
G. K. CROMPTON, J. G. AYRES, G. BASRAN, G. SCHIRALDI, V. BRUSASCO, A. EIVINDSON, A. H. JAMIESON, and H. OLSSON
Comparison of Oral Bambuterol and Inhaled Salmeterol in Patients with Symptomatic Asthma and Using Inhaled Corticosteroids
Am. J. Respir. Crit. Care Med., March 1, 1999; 159(3): 824 - 828.
[Abstract] [Full Text]

Home page
 Am. J. Respir. Crit. Care Med.Home page
R. J. MARTIN and S. BANKS-SCHLEGEL
Chronobiology of Asthma
Am. J. Respir. Crit. Care Med., September 1, 1998; 158(3): 1002 - 1007.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1995 by the American College of Chest Physicians.