title: Effect of solution and suspension type aerosol of formoterol on tremor response and airways in patients with asthma.
abstract: BACKGROUND
  Aerosol delivery and deposition to the oropharynx and the lungs have been found to be different for solution-type and suspension-type metered-dose aerosols used for treatment of asthma. We investigated possible differences in clinical effects between solution and suspension metered-dose formoterol aerosols.
  
  
  METHODS
  A total of 24 patients with asthma (forced expiratory volume in 1 second, < or = 70% predicted) inhaled single doses (12 micrograms or 24 micrograms) of formoterol solution and suspension so that we could investigate the immediate tremor, airway, and cardiovascular responses in a randomized, double-blind, crossover trial. Fenoterol suspension aerosol (400 micrograms) was used for comparison (single-blind, poststudy, nonrandomized administration). Fenoterol (400 micrograms) as a rescue medication was inhaled after 120 minutes on each of the 5 study days.
  
  
  RESULTS
  The order of mean (+/- SEM) maximum tremor acceleration was as follows: 12 micrograms formoterol solution (67.92 +/- 4.54 cm x sec-2) < 24 micrograms solution (73.46 +/- 4.51 cm x sec-2) < 12 micrograms suspension (80.87 +/- 5.08 cm x sec-2) < fenoterol (84.13 +/- 4.21 cm x sec-2) < 24 micrograms formoterol suspension 88.54 +/- 6.26 cm x sec-2). Maximum increase in specific airway conductance ranged from 0.48 +/ 0.03 to 0.55 +/- 0.04 sec-1 x kPa-1 for all drugs (p > 0.05). No change in cardiovascular parameters occurred (p > 0.05).
  
  
  CONCLUSIONS
  No difference in the bronchial response to either formulation of formoterol was found. Tremor response to suspension aerosol (24 micrograms > 12 micrograms) was higher than that to solution aerosol (24 micrograms > 12 micrograms), indicating possible differences in systemic absorption because of a different deposition pattern. Rescue medication demonstrated systemic effects on tremor that were additive to those of formoterol.
authors.affiliation: Department of Pneumology, University of Vienna Medical School, Austria.
authors.forename: K
authors.initials: K
authors.lastname: Bauer
authors.forename: K
authors.initials: K
authors.lastname: Sertl
authors.forename: B
authors.initials: B
authors.lastname: Kaik
authors.forename: G
authors.initials: G
authors.lastname: Kaik
mesh_terms: D000328:Adult; D000336:Aerosols / Q000145:classification; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002319:Cardiovascular System / Q000187:drug effects; D004311:Double-Blind Method; D016503:Drug Delivery Systems; D004983:Ethanolamines / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005280:Fenoterol / Q000627:therapeutic use; D000068759:Formoterol Fumarate; D006801:Humans; D008297:Male; D008875:Middle Aged; D012123:Pulmonary Ventilation / Q000187:drug effects; D012137:Respiratory System / Q000187:drug effects*; D012996:Solutions; D013535:Suspensions; D014202:Tremor / Q000139:chemically induced* / Q000503:physiopathology
chemical_list: D000336:Aerosols; D001993:Bronchodilator Agents; D004983:Ethanolamines; D012996:Solutions; D013535:Suspensions; D005280:Fenoterol; D000068759:Formoterol Fumarate