The Science Journal of the American Association for Respiratory Care

2001 OPEN FORUM Abstracts

A COMPARISON OF THEUSE OF LEVALBUTEROL COMPARED TO RACEMIC ALBUTEROL IN THE PULMONARY STEPDOWNPOPULATION

John Davies RRT,Neil MacIntyre MD, Greg Ahearn MD, Boyd Hudson RRT, Bill Webb RRT Duke UniversityMedical Center, Durham, NC.

HYPOTHESIS: Racemic Albuterolconsists of both an R-isomer and an S-isomer. The R-isomer is responsible forbronchodilation. The S-isomer was originally thought to be inert, but recentevidence appears to relate it to unwanted side effects. Levalbuterol is a newpreparation that contains only the R-isomer and has a longer duration than racemicalbuterol. We hypothesized that routine use of levalbuterol administered TIDwould require fewer overall as well as PRN treatments than racemic albuteroladministered QID.

METHOD: The study designwas a three month observational period using levalbuterol TID + prn insteadof racemic albuterol QID + prn as the standard beta agonist bronchodilator therapyon our pulmonary step-down unit. The same three month period during the previousyear when racemic albuterol was the standard beta agonist bronchodilator therapywas used as a historical control period. Total and prn treatments/patient werecalculated during both periods and compared using unpaired T tests.

Results: The total numberof treatments decreased from 3835 during the control period to 2613 when Levalbuterolwas used (3.5 treatments per patient day and 2.8 treatments per patient dayrespectively ? p < 0.05). The number of PRN treatments declined from 540during the control period (Racemic Albuterol) to 375 during the levalbuterolperiod (0.5 prn treatments and 0.4 prn treatments per patient day respectively- p < 0.05).

CONCLUSION: Levalbuterol1.25 mg delivered on a TID + PRN basis results in fewer PRN treatments per patientday as compared to the Administration of Racemic Albuterol 2.5 mg QID +PRN.

Note: Sponsored in part by Sepracor.

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