BRONCHODILATOR EFFECT OF SALBUTAMOL GIVEN BY DOSIMETER AND CONTINUOUSNEBULIZATION WITH AN INTERMITTENT POSITIVE PRESSURE BREATHING DEVICE

The bronchodilator effect of salbutamol delivered by an inhalation-syn chronized dosimeter nebulizer was compared with that delivered by an i ntermittent positive pressure breathing (IPPB) device in 11 asthmatic patients. The study was a randomized, two-period crossover study with an open design. Salbutamol aerosol was delivered by the dosimeter in s uccessive cumulative doses of 50, 100, 200, 500, and 1000 mug, and by the IPPB device in doses of 0.2, 0.5, 1, 2, and 5 mg. There were 30-mi nute intervals between each dose of salbutamol, and pulmonary function was measured both before the drug's administration and 15 minutes aft er each dose. No dose increments were given once the dose response cur ve had reached a plateau. The treatments were given on 2 successive da ys, at the same time each morning. The mean doses required to achieve the highest forced expiratory volume in 1 second (FEV1) were very smal l for both techniques-0.41 mg for the IPPB device and 0.17 mg for the dosimeter, the latter being significantly smaller (P = 0.04). The high est FEV1 was significantly better with the IPPB device than with the d osimeter (P = 0.006); however, the highest forced vital capacity was s imilar with both techniques. We conclude that the dosimeter nebulizer is a drug-sparing, convenient, and efficient technique in aerosol drug therapy.