Inhaled furosemide is not effective in acute asthma.
As previous studies have suggested that inhaled furosemide may have a protective effect against certain types of provocative challenges in asthmatic subjects, we investigated the role of furosemide in treating acute asthma exacerbations. Twenty-four patients (n = 24) with acute asthma were entered into the study on presenting to the emergency department. They were blindly randomized to receive one of three drug regimens: (1) inhaled furosemide (40 mg) (n = 8); (2) inhaled metaproterenol (15 mg) (n = 7); or (3) the combination of furosemide (40 mg) and metaproterenol (15 mg) (n = 9). We measured FEV1 at entry (time 0) and 15, 30, 45, and 60 min after inhalation of the individual drugs or the combination from a face mask nebulizer. At entry, the three groups did not differ significantly in age (mean +/- SEM = 37.6 +/- 3.6, 38.5 +/- 3.6, and 41.0 years, respectively; p = 0.770), baseline FEV1 (1.01 +/- 0.27, 1.04 +/- 0.27, and 1.25 +/- 0.14 L, respectively; p = 0.620), or theophylline levels (2.87 +/- 1.8, 7.39 +/- 2.8, and 5.29 +/- 2.6 micrograms/ml, respectively; p = 0.498). Pretreatment and posttreatment potassium levels were similar among the three groups. Inhalation of furosemide alone resulted in a 14.9 +/- 10.5 percent change in FEV1 percent from baseline, which was not statistically significant. In contrast, metaproterenol alone resulted in a 42.9 +/- 15.2 percent increase in FEV1 percent (F ratio = 6.226; p = 0.0028). The combination of furosemide and metaproterenol resulted in a change in FEV1 percent that was not statistically different compared with metaproterenol alone (FEV1 percent = 41.9 +/- 12 percent). No significant adverse effects occurred in any of the groups.
Karpel
J P
JP
Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY 10467.
Dworkin
F
F
Hager
D
D
Feliciano
S
S
Shapiro
D
D
Posner
L
L
Luks
D
D
D000208:Acute Disease; D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D005541:Forced Expiratory Volume / Q000187:drug effects; D005665:Furosemide / Q000008:administration & dosage*; D006801:Humans; D009921:Metaproterenol / Q000008:administration & dosage; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D013997:Time Factors
D009921:Metaproterenol; D005665:Furosemide