Terbutaline vs albuterol for out-of-hospital respiratory distress: randomized, double-blind trial.
OBJECTIVE
To determine the efficacy and safety of single doses of subcutaneous terbutaline (TERB) or nebulized albuterol (ALB) during out-of-hospital treatment for respiratory distress from asthma or chronic obstructive pulmonary disease.


METHODS
Patients aged > 18 years who had respiratory distress were enrolled in a double-placebo, double-blind, randomized trial. Paramedics measured respiratory severity using an empiric score [respiratory rate, wheezing, speech, and peak expiratory flow rate (PEFR)], and the patients rated their own respiratory distress using a visual analog scale (VAS). The patients received O2 plus ALB (2.5 mg) and saline injection (n = 40) or TERB (0.25 mg) and saline aerosol (n = 43).


RESULTS
The groups were similar with respect to age, gender, initial empiric scores (median score 9 for both groups), PEFRs (89 +/- 84 L/min, mean +/- SD, for ALB vs 97 +/- 84 L/min for TERB), and respiratory distress VAS scores. Both groups showed significant improvement in their respiratory distress VAS scores by the time of ED arrival. The ALB group had a greater improvement in respiratory distress VAS score than did the TERB group (p < 0.05). Empiric scores, PEFR scores, and hospital admission frequencies were not significantly different. No complication was observed.


CONCLUSIONS
The out-of-hospital administration of either aerosolized ALB or subcutaneous TERB reduced respiratory severity. Albuterol provided greater subjective improvement in respiratory distress.
Zehner
W J
WJ
Department of Emergency Medicine, SUNY Health Science Center, Syracuse 13210, USA.
Scott
J M
JM
Iannolo
P M
PM
Ungaro
A
A
Terndrup
T E
TE
D000280:Administration, Inhalation; D000328:Adult; D000368:Aged; D000420:Albuterol / Q000627:therapeutic use*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D004311:Double-Blind Method; D004417:Dyspnea / Q000188:drug therapy* / Q000209:etiology; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008173:Lung Diseases, Obstructive / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010366:Peak Expiratory Flow Rate / Q000187:drug effects; D011446:Prospective Studies; D012720:Severity of Illness Index; D013726:Terbutaline / Q000627:therapeutic use*
D001993:Bronchodilator Agents; D013726:Terbutaline; D000420:Albuterol