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Single-isomer R-salbutamol is not superior to racemate regarding protection for bronchial hyperresponsiveness
Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Anaesthesiology. Östergötlands Läns Landsting, Anaesthesiology and Surgical Centre, Department of Intensive Care UHL.
Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of cell biology.
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2004 (English)In: Respiratory Medicine, ISSN 0954-6111, Vol. 98, no 10, 990- p.Article in journal (Refereed) Published
Abstract [en]

Bronchial hyper-reactivity (BHR) has been suggested to follow cessation of regular medication with racemic salbutamol. This study aimed at investigating the effects from medication with R,S- and R-salbutamol on bronchial response to provocation with isocapnic hyperventilation of cold air (IHCA). Twenty-six patients with mild to moderate asthma were enrolled in a double-blind, randomised, cross-over study. Bronchial response to provocation was measured before and after 1 week's medication. Doses of 0.63 mg R-salbutamol or 1.25 mg R/S-salbutamol were inhaled three times daily during medication-weeks and a wash-out week intervened. Tests were performed 6 h after the last dose of test drug. Impulse oscillometry and forced expiratory volume during one second were methods used to identify bronchial response to provocation. Two patients withdrew from the investigation due to side-effects, one from R- the other from R,S-salbutamol. Comparable resting bronchial conditions were indicated by differences in baseline lung function values of <2% between study days. No statistically significant medication-dependent differences in BHR could be demonstrated between treatment groups. However, 15 patients exhibited higher (P=0.03) post-treatment BHR after pure R-salbutamol than after R,S-salbutamol. Furthermore, plasma concentrations of R-salbutamol tended to be lower (P=0.08) after medication with R- than after R,S-salbutamol despite equal doses of R-salbutamol given during the two separate treatment periods. We also found that considerable amounts of S-salbutamol were retrieved in plasma after medication with pure R-salbutamol. We conclude that we were unable to demonstrate favourable effects of R-salbutamol over R,S-salbutamol regarding response to provocation with IHCA after regular medication of 1 week's duration.

Place, publisher, year, edition, pages
2004. Vol. 98, no 10, 990- p.
Keyword [en]
bronchial hyperresponsiveness, salbutamol, enantiomer, asthma, IOS
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-24257DOI: 10.1016/j.rmed.2004.03.005Local ID: 3859OAI: diva2:244574
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2011-01-12

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Naidu-Sjöswärd, KerstinDavidsson, AnetteSöderkvist, PeterSchmekel, Birgitta
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Faculty of Health SciencesAnaesthesiologyDepartment of Intensive Care UHLClinical PhysiologyDepartment of Clinical PhysiologyDivision of cell biology
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Respiratory Medicine
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