Evaluation of tremor and efficacy of oral procaterol in adult patients with asthma.
Tremor, the most common side effect of ordinary doses of beta 2-agonists, was evaluated in a quantitative manner and compared to improvement in pulmonary function in respect to time of onset, duration, peak effect, and tachyphylaxis with procaterol in adults. Forty-five adult patients with reversible obstructive airway disease were studied during administration of three different dosages of procaterol, 25 micrograms escalating to 100 micrograms, and 100 micrograms twice daily. Tremor was quantitatively evaluated with a Grass model accelerometer. The patients were evaluated during 8 hours approximately every 2 weeks for 8 weeks. Daily diaries of symptoms and side effects were also maintained. The study demonstrated no direct relationship between tremor and pulmonary function as far as time of onset, peak effect, or duration. Although tachyphylaxis was demonstrated, much of the tolerance developed to the tremor was explained by an increase in baseline tremor. Procaterol was demonstrated to be an effective bronchodilator, and tolerance to tremor was demonstrated to develop with time but is highly variable. There was not a direct relationship between tremor and pulmonary function, indicating possible differences between lung and peripheral muscle beta 2-receptors. It appeared that the best way to minimize the problem of tremor is to begin with a lower dose and increase the dose gradually during a period of weeks.
Tinkelman
D G
DG
Atlanta Allergy Clinic, GA 30328.
DeJong
R
R
Lutz
C
C
Spangler
D L
DL
D000284:Administration, Oral; D000318:Adrenergic beta-Agonists / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D001249:Asthma / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D002986:Clinical Trials as Topic; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004983:Ethanolamines / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D008297:Male; D008450:Maximal Midexpiratory Flow Rate / Q000187:drug effects; D008875:Middle Aged; D017265:Procaterol; D011897:Random Allocation; D014202:Tremor / Q000139:chemically induced / Q000503:physiopathology*
D000318:Adrenergic beta-Agonists; D004983:Ethanolamines; D017265:Procaterol