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 a sthmatic subjects, we investigated the role of furosemide in treating acute asthma exacerbations. Twenty-four patients (n = 24) with acute a sthma were entered into the study on presenting to the emergency depar tment. They were blindly randomized to receive one of three drug regim ens: (1) inhaled furosemide (40 mg) (n = 8); (2) inhaled metaprotereno l (15 mg) (n = 7); or (3) the combination of furosemide (40 mg) and me taproterenol (15 mg) (n = 9). We measured FEV(1) at entry (time 0) and 15, 30, 45, and 60 min after inhalation of the individual drugs or th e combination from a face mask nebulizer. At entry, the three groups d id not differ significantly in age (mean +/- SEM = 37.6 +/- 3.6, 38.5 +/- 3.6, and 41.0 years, respectively; p = 0.770), baseline FEV(1) (1. 01 +/- 0.27, 1.04 +/- 0.27, and 1.25 +/- 0.14 L, respectively; p = 0.6 20), or theophylline levels (2.87 +/- 1.8, 7.39 +/- 2.8, and 5.29 +/- 2.6 mu g/ml, respectively; p = 0.498). Pretreatment and posttreatment potassium levels were similar among the three groups. Inhalation of fu rosemide alone resulted in a 14.9 +/- 10.5 percent change in FEV(1) pe rcent from baseline, which was not statistically significant. In contr ast, metaproterenol alone resulted in a 42.9 +/- 15.2 percent increase in FEV(1) percent (F ratio = 6.226; p = 0.0028). The combination of f urosemide and metaproterenol resulted in a change in FEV(1) percent th at was not statistically different compared with metaproterenol alone (FEV(1) percent = 41.9 +/- 12 percent). No significant adverse effects occurred in any of the groups.