The Science Journal of the American Association for Respiratory Care

2003 OPEN FORUM Abstracts

The Impact of Xopenex Substitution In place Of Albuterol.

Thomas Serrano, RCP, BS RRT., Hal Herlong, RCP, BS RRT-NPS., Kiumars Saketkhoo, MD., Nadeem Chishti, MD., Bill Richelieu, PharmD. Presbyterian Intercommunity Hospital, Whittier, California.

Object: To assess the impact of converting hand held nebulized treatments given with 1.25 mg and 2.5 mg Abuterol with a typical frequency of Qid, to Xopenex 0.63 mg at a Q6-q8h frequency. 

: All patients that were under the care of the participating pulmonologist were included except asthmatics. Patients that were admitted through the Emergency department for respiratory distress was treated Q6 hours for 24 hours then converted over to Q8 hours and prn. All PRN treatments were given with1.25 mg Albuterol. Trial period for study was from June-August of 2002 with retrospective data from June-August of 2001. Measurements consisted of total number of treatments, number of prn treatments, length of stay in hospital (LOS), number of patients receiving steroids and antibiotics and cost.

: The total number of treatments given with Xopenex was 1,156 compared to 2,013 from baseline. Number of PRN treatments given with Xopenex 28 treatments compared to 102 from baseline. Number of patients receiving antibiotics 92% compared to 83% from baseline. Number receiving steroids 41% compared to 58% from baseline. Average LOS was 7.8 days VS 7.6 days from baseline. Medication cost with Xopenex was 1,930.52 compared to 624.03 with Albuterol during baseline year. Labor cost 10,407.12 compared to 15,386.03 from baseline. 

The use of Xopenex appears to have lasting effect as reflected in the decrease amount of unscheduled treatments. The cost saving anticipated in labor was realized in the study. What was not fully appreciated till the time of the study was the impact upon the evening shift between the hours on 1900-2300 due to the Q8 hour frequency. The slight increase in LOS may be the result of inclusion of patients that were transferred to the Transitional Care Unit. 

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