Beswick K et al, 1975, UK | 20 patients in GP setting with acute bronchospasm | Single blinded randomised trial of IV salbutamol or aminophylline | Vital signs PEFR FEV1 FVC | Same Difference favouring salbutamol at 10 and 20 min but not significant | Small non-ED study (most treated at home) |
| | | Side effects | Significantly worse profile for aminophylline | |
Williams SJ et al, 1975, Wales | 20 acute asthmatic patients with peak flow <25% predicted, Pao2<68 mm Hg | DBRCT One hour infusion of either 500 μg aminophylline or 500 g salbutamol | Peak flow Pulse | Increased but not significant for salbutamol More tachycardia (significant) with salbutamol | Small numbers |
| | | BP | Fall in diastole | |
| | | Side effects | Less tremor, nausea, no difference in plasma [K+] | |
Tribe AE et al, 1976, Australia | 23 acute asthma patients | DBRCT of IV aminophylline v salbutamol | Spirometry | Non-significant benefit and peak effect of aminophylline | Suboptimal dose of salbutamol |
| | | ABG | Quicker improvement in oxygen tension with salbutamol | Variable pre-trial treatment |
Femi-Pearse D et al, 1977, Nigeria | 50 patients with peak flow <165l/min | Single and double blinded trials of salbutamol and aminophylline | Five minutely pulse and peak flow measures | Significant benefit in peak flow at 5 min (p<0.005) and 20 min (p<0.05) for single blinded trial only for salbutamol. No difference in pulse rate | Small trial Low dose of salbutamol |
Johnson AJ et al, 1978, UK | 39 of 62 acute asthmatic patients unresponsive to initial IV 10 min aminophylline infusion and nebulised salbutamol | Single blinded RCT Either 1 mg/min aminophylline or 10 μg/min salbutamol | Peak expiratory flow FEV1 | Non-significant benefit of aminophylline Non-significant benefit of salbutamol | All received IV aminophylline initially No initial bolus of salbutamol |
| | | FVC | Non-significant benefit of aminophylline | Variable used of nebulised salbutamol acutely |
| | | Arterial gas measurements | No difference | Not blinded to physicians |
| | | Pulse and BP | Significant tachycardia in salbutamol group | Variable background preventive treatment |
Evans WV et al, 1980, UK | 21 acute asthma patients | Single blinded RCT comparing aminophylline, salbutamol or combined IV | Spirometry | Non-significantly quicker time to improvement with aminophylline and combined infusion | Small numbers Variable baseline severity Sub-therapeutic salbutamol dosing |
Sahay JN et al, 1984, UK | 20 adults with FEV1<70% predicted | Double blinded RCT crossover of aminophylline, terbutaline and salbutamol | Spirometry | All produced significant improvement, salbutamol significantly better than aminophylline to 30 min after dose then no difference with better peak effect. | Small group, not acutely unwell |
| | | Vital signs and side effects | Salbutamol significantly more tachycardia and palpitations which return to no difference at 90 min | |
Sharma TN et al, 1984, India | 30 known asthmatic patients with acute bronchospasm | RCT of aminophylline, salbutamol or terbutaline | Spirometry | Salbutamol significantly better FEV1 | Blinding not clear |
| | | Side effects | Significantly more palpitations with salbutamol | Salbutamol 250 μg given as 1 min bolus |
Grief J et al, 1985, Israel | 21 patients (mean age 38 years) with acute or chronic asthma | Single blinded crossover 20 min infusion of salbutamol or aminophylline | % Increase in peak flow | Salbutamol shows significant benefit to 30 min (p<0.01) and 45 min (p<0.05) after infusion | Small study |
| | | Pulse rate | Tachycardia with salbutamol | |
| | | BP | No difference | Not fully blinded |
| | | Plasma [K+] | Average drop of 0.6 mmol/l | |
| | | Tremor | More in salbutamol group | |