Efficacy of Inhaled Levalbuterol Compared to Albuterol in Horses with Recurrent Airway Obstruction.
BACKGROUND
The (R)-enantiomer of racemic albuterol (levalbuterol) has bronchodilatory properties whereas the (S)-enantiomer causes adverse effects in human airways, animal models, and isolated equine bronchi. Levalbuterol is commercially available and improves pulmonary function of asthmatic patients with a longer duration of effect than albuterol.


OBJECTIVE
To determine the dose at which inhaled levalbuterol produces maximal bronchodilatory effect (EDmax) and determine its duration of action in recurrent airway obstruction (RAO)-affected horses in comparison to racemic albuterol.


METHODS
Nine horses with inducible and reversible RAO.


METHODS
Randomized, crossover trial. Horses were challenged with moldy hay to induce airway obstruction. Horses were treated with nebulized albuterol or levalbuterol chosen randomly. Pulmonary function testing (PFT) was measured before and for up to 3 hours after bronchodilatation challenge. Maximum change in transpulmonary pressure (DPmax ) was measured to assess the dose effect and duration of action of each drug. After a 24 hours washout period, the bronchodilatation challenge was repeated with the second bronchodilator.


RESULTS
The duration of effect was 60 minutes for albuterol and 120 minutes for levalbuterol. The dose of bronchodilator EDmax was not significantly different between albuterol and levalbuterol (EDmax = 125.0 [125-125 μg] and EDmax = 188 [125-188 μg] respectively; P = .068). The magnitude of bronchodilatation was not significantly different between the 2 treatments (61.1 and 59.9% decrease in DPmax for albuterol and levalbuterol respectively; P = .86).


CONCLUSIONS
Levalbuterol is as effective a bronchodilator as albuterol; although levalbuterol lasts twice as long as albuterol, its duration of action is still too short to make it practical for RAO treatment.
Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN.
M G
MG
Arroyo
Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN.
L L
LL
Couëtil
Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN.
N
N
Nogradi
Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN.
M M
MM
Kamarudin
Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN.
K M
KM
Ivester
D000420:Albuterol / Q000008:administration & dosage / Q000627:therapeutic use*; D000818:Animals; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use; D018592:Cross-Over Studies; D005260:Female; D006734:Horse Diseases / Q000188:drug therapy*; D006736:Horses; D064412:Levalbuterol / Q000008:administration & dosage / Q000627:therapeutic use*; D008173:Lung Diseases, Obstructive / Q000188:drug therapy / Q000662:veterinary*; D008297:Male
D001993:Bronchodilator Agents; D064412:Levalbuterol; D000420:Albuterol
Aerosol treatment; Bronchodilator; Heaves