Domiciliary nebulized beta-agonists. Long-term treatment in asthmatics, and drug intake and plasma levels in acute asthma.

Long-term domiciliary treatment with nebulized salbutamol was studied in 27 patients (mean age 55 years, range 25-77) suffering from severe chronic bronchial asthma. At the end of the treatment period (mean 2.7 years, range 0.9-3.9) three patients had returned their Pari Inhalierboy nebulizers, two because of improvement, one because of moving from the area. Two patients died at home from status asthmaticus. Of the rest, about a third experienced an improved quality of life, and six of 9 patients depending on oral corticosteroids could be transferred to metered dose aerosols. No significant changes of the number of days in hospital or on sick-leave, number of hospitalizations or number of outpatient consultations between corresponding periods before and after the start of nebulizing therapy at home were found. In another study, drug intake 24 h before hospital admission and plasma levels of beta-agonists were recorded in 45 asthmatics (mean age 52 years, range 20-74) on arrival at hospital with acute asthma (PEFR less than 50% predicted normal value, pulse rate greater than 100). In 22 of the 64 acute episodes recorded, domiciliary nebulized beta-agonists were used. No significant differences in the oral doses taken 24 h before arrival or the plasma concentrations of beta-agonists were found between patients with and without nebulized beta-agonists. The studies demonstrate the feasibility of home-treatment with beta-agonists via nebulizers.