[Effect of high doses of broncholytics on the state of cardiovascular system during treatment of sever exacerbation of bronchial asthma].
The use of broncholytic drugs through nebulizer is a standard treatment for acute episodes of bronchial asthma. However doses of these drugs administered by nebulizer can be much higher than those applied when metered dose inhaler is used. These doses have a potential of cardiotoxic effects.


METHODS
Patients (n=75) with severe exacerbation of bronchial asthma.


METHODS
All patients received broncholytic drugs through nebulizer. Doses were adjusted according to age and concomitant pathology among which prevailed ischemic heart disease (21.3%) and hypertension (53.3%). Nebulized beclomethasone was an alternative to systemic corticosteroids. Safety of therapy was controlled with electrocardiography, 24-hour electrocardiography, measurements of serum potassium level, registration of subjective signs (palpitation, tremor) and objective data (heart rate, blood pressure).


RESULTS
Clinical improvement occurred in all patients. By the end of nebulizer therapy arterial blood O(2) saturation increased 4.66% from initial level (p=0.04). Peak expiratory rate and forced expiratory volume in 1 sec also rose (p <0.05). Termination of nebulizer therapy was associated with decrease of number of both supraventricular and ventricular premature beats. Moderate widening of of QT interval above 460 ms was registered in 4 patients, 3 of whom had ischemic heart disease. There were no significant changes of serum potassium levels.


CONCLUSIONS
Broncholytic drugs administered by nebulizer in therapeutic doses selected with consideration of age and concomitant diseases did not produce cardiotoxic effects.
Makolkin
V I
VI
Ovcharenko
S I
SI
Peredel'skaia
O A
OA
Axel'rod
A S
AS
D000318:Adrenergic beta-Agonists / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D000420:Albuterol / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D005260:Female; D005280:Fenoterol / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D009241:Ipratropium / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D016896:Treatment Outcome
D000318:Adrenergic beta-Agonists; D001993:Bronchodilator Agents; D004338:Drug Combinations; C030809:fenoterol, ipratropium drug combination; D005280:Fenoterol; D009241:Ipratropium; D000420:Albuterol