Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Our investigation supports the use of intravenous salbutamol as an alternative to aminophylline in the early stages of acute severe asthma. Salbutamol proved to be a marginally better bronchodilator and is likely to cause less gastrointestinal side effects than aminophylline, but tachycardia and generalized tremor are more frequent with this drug.
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PMID:Comparison of intravenous salbutamol (albuterol) and aminophylline in the treatment of acute asthmatic attacks. 389 25

1. (-)-Isoprenaline, salbutamol, orciprenaline and quinterenol injected intravenously decreased the tension and degree of fusion of incomplete tetanic contractions of the soleus muscle of the anaesthetized cat.2. Under the most sensitive conditions, the smallest effective dose of (-)-isoprenaline was of the order of 0.01 mug/kg intravenously. Salbutamol was usually 6-10 times, orciprenaline 20-30 times and quinterenol about 35 times less potent than isoprenaline. The effects of salbutamol were about 1.6 times, of orciprenaline about 1.8 times and of quinterenol more than 20 times as long lasting as those of (-)-isoprenaline.3. The effects of the sympathomimetic amines were blocked by propranolol, H56/28, H35/25 and butoxamine but not by ICI 50172. The combined results with agonists and antagonists indicate that the receptors involved can be classified as of the beta(2) type.4. The effect of the amines on the cat soleus muscle appears to be analogous to that causing enhancement of physiological tremor in man, which suggests that skeletal muscle tremor may be an occasional unwanted side effect of the use of these bronchodilators.
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PMID:Actions of some sympathomimetic bronchodilator and beta-adrenoceptor blocking drugs on contractions of the cat soleus muscle. 439 35

Albuterol is a long-acting beta 2-adrenergic receptor-selective drug that relaxes airway smooth muscle. It is currently available in the United States in oral and metered-dose inhaler forms. Nebulizer solutions and parenteral preparations are likely to be marketed here in the future. The chemical modifications that make albuterol beta 2-selective also promote oral bioavailability and increased duration of action by decreasing sensitivity to degradative enzymes. Albuterol can also produce undesirable dose-related effects: metabolic effects including decreased levels of plasma potassium, phosphate, calcium and magnesium; increased levels of plasma glucose, insulin, renin, lactate and ketones; peripheral vasodilation and perhaps some direct cardiac stimulation resulting in decreased systemic and pulmonary vascular resistance, increased pulse pressure and tachycardia; and skeletal muscle tremor. These side effects are most common with parenteral administration and much less prominent with aerosol administration, which yields lower systemic concentrations. Limited pharmacokinetic data suggest a long distribution phase, a terminal half-life of 3-8 hours, and 10-20% oral bioavailability. Aerosolization of albuterol or a similar agent with a compressed-air nebulizer appears to be best first-line management of the patient with acute dyspneic asthma, but appropriate preparations for this kind of therapy are currently missing from the United States market. Intravenous albuterol has also been employed in acutely dyspneic patients, but produces more side effects than carefully administered intravenous theophylline, is impaired by lack of sufficient pharmacokinetic information to guide dosing, and is of uncertain efficacy in the asthmatic with respiratory failure. However, it appears to lack the potentially life-threatening side effects that can result when theophylline is used carelessly . In the ambulatory patient, aerosolized albuterol (or a similar agent) administered by metered-dose inhaler is an excellent agent for treatment as needed and/or for prevention of acute bronchospasm triggered by exercise or other predictable cause. Advantages include a high degree of efficacy, rapid onset and long duration of effect, and minimal side effects. Regularly scheduled administration of albuterol by metered-dose inhaler is a widely used and effective maintenance medication for patients requiring long-term prophylactic therapy. However comparisons of the ability of this regimen and the other common maintenance regimens (cromolyn and theophylline) to control chronic symptoms of asthma are needed.
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PMID:Albuterol: an adrenergic agent for use in the treatment of asthma pharmacology, pharmacokinetics and clinical use. 673 11

Although albuterol aerosol is an effective bronchodilator in adult asthmatics its efficacy and safety are not fully established in asthmatic children. Albuterol (100 and 200 micrograms), isoproterenol (70 and 140 micrograms) and placebo were administered from metered dose aerosol cannisters to 11 asthmatic children (9 to 16 years of age). Our findings indicate that in asthmatic children albuterol aerosol causes bronchodilation for up to six hours and greater bronchodilation than comparable doses of inhaled isoproterenol and does not produce overt effects on the cardiovascular system, significant changes in arterial partial pressure of oxygen or excessive tremor.
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PMID:Double-blind comparison of acute effects of inhaled albuterol, isoproterenol and placebo on cardiopulmonary function and gas exchange in asthmatic children. 684 20

Salbutamol solution is usually administered by nebuliser in a dose of 5 mg. Little evidence exists that this is the optimal dose for bronchodilatation or that this dose is without side-effects. Twelve patients with asthma were given increasing doses of salbutamol 1.5 mg, 3.0 mg, 7.5 mg, and placebo. Treatments were administered twice daily for four days in a double-blind manner. Measurements of ventilatory capacity, pulse rate, and tremor were recorded before and for three hours after treatment. There was a significant dose-related response for FEVI and peak flow rate. There was also a significant dose-related response in pulse rate and tremor. The incidence of palpitations was similarly related to dose. Plasma levels of salbutamol were measured before and after treatment with salbutamol and showed a dose related increase in salbutamol absorption which begins to be evident after the 3.0 mg dose. Three milligrams of salbutamol nebuliser solution may be an optimal dose, producing satisfactory bronchodilatation but fewer side-effects related to systemic absorption.
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PMID:Optimal dose of salbutamol respiratory solution: comparison of three doses with plasma levels. 703 74

The aim of the study was to compare the efficacy, tolerability and patient acceptability of bambuterol (Bambec) against controlled release (CR) salbutamol (Volmax) in the treatment of nocturnal asthma. One hundred and fifty two asthmatic patients aged 17-78 years, using > or = 800 micrograms/day of an inhaled steroid, with nocturnal asthma symptoms, openly received three weeks of bambuterol 20 mg nocte and three weeks of salbutamol CR 8 mg b.i.d. in a randomised, cross over sequence. Both bambuterol and salbutamol CR treatment produced a significant 63% decrease in the severity of baseline nocturnal asthma symptoms. This improved control of nocturnal asthma was reflected by significant improvements in baseline lung function. Both the severity and number of days of tremor during the first week of treatment was significantly lower with bambuterol than with salbutamol CR. Patients considered bambuterol to cause less shakiness and treatment preference was bambuterol 49%, salbutamol CR 36%, no preference 15%. The predominant reason for patient treatment preference was control of asthma symptoms, however a significant sub-group of patients (27%) chose bambuterol because of fewer adverse effects compared to 11% choosing salbutamol CR. Fifty six percent of patients preferred taking their medication once-daily and 7% preferred twice-daily. This study shows that both bambuterol and salbutamol CR are equally effective treatments for nocturnal asthma in patients already receiving inhaled steroid. The most important factor in terms of patient treatment acceptability appears to be control of symptoms. Sub-groups of patients may chose bambuterol due to its better adverse effect profile and once-daily regimen.
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PMID:Comparison of the efficacy, tolerability and patient acceptability of once-daily bambuterol tablets against twice-daily controlled release salbutamol in nocturnal asthma. ACROBATICS Research Group. 762 43

Albuterol has been proven to be a vital component in the management of severe, acute asthma in children and adults. Continuous nebulization of albuterol is a relatively new administration technique for treating patients with unresponsive asthma. This method may offer the advantages of greater penetration of drug into the lung, reduced bronchospasm, and a more rapid and sustained response. In clinical trials, continuous nebulization has been shown to be as effective as intermittent nebulization and may be associated with a reduction in the need for hospital admission, length of hospital stay, and the use of mechanical ventilation. Adverse effects observed with albuterol use, including tremor, metabolic disturbances, and cardiotoxicity, are rare and appear to be no more prevalent with the continuous method of nebulization.
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PMID:Administration of albuterol by continuous nebulization. 774 30

Salbutamol in controlled release tablet form was compared to salbutamol in standard tablet form for the management of patients with bronchial asthma. A total of twenty asthmatic patients enrolled in the study were classified into two groups, ten patients each, for a cross-over study. Group 1 received controlled release tablets for a 2 to 3 week period, and were then shifted to standard tablets for another similar period. Group 2 received standard tablets first and was then shifted to controlled release tablets. Patients were required to record symptom scores during therapy, including sleep disturbance, chest tightness, wheezing, cough, sputum production and inhalational bronchodilator use. Measurements of peak expiratory flow rate (PEFR) were also done, as well as record made of side effects experienced. The result showed that a lower symptom score was found in patients receiving controlled release tablets than in patients receiving standard tablets (p < 0.001 for sleep disturbance, p < 0.005 for sputum formation and p < 0.001 for total score). There was a higher PEFR in patients receiving controlled-release tablets than in patients receiving standard tablets (p < 0.001). Side effects with tremor were observed in 30% of both groups of patients with a slightly higher degree in the patients receiving standard tablets (statistically not significant). In conclusion, salbutamol of controlled release tablet form obtains a better therapeutic response than standard tablets in the management of patients with bronchial asthma.
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PMID:Salbutamol in treatment of bronchial asthma--comparison of controlled release tablet with standard tablet. 798 68

The acute safety of the alternative chlorofluorocarbon-free (CFC-free) propellant HFA-134a from a pressurized metered-dose inhaler (MDI) was assessed in 12 healthy male subjects according to a double-blind, randomized, crossover design. On each of three consecutive days, cumulative doses of 1,2,4,8 and 16 inhalations were administered 30 min apart from one of three MDIs. The three MDIs contained either the HFA-134a CFC-free system without drug (HFA-Placebo), the CFC-free system with salbutamol sulphate (HFA-Salbutamol), or a conventional CFC propellant mixture without drug (CFC-Placebo). Pulmonary function (FEV1, FEF25-75%), cardiovascular performance (heart rate and blood pressure), objective tremor measurements and serum potassium were measured after each incremental dose. Similar responses for pulmonary function, cardiovascular performance, tremor and serum potassium were observed between the HFA-Placebo and CFC-Placebo groups. No statistically significant difference was seen in change from baseline of any parameter between the two propellant systems. The administration of HFA-Salbutamol produced statistically significant dose-related increases in heart rate, systolic blood pressure and tremor and a significant dose-related decrease in serum potassium; these responses were expected based on cumulative doses of active drug. Blood samples for HFA-134a analysis were collected to measure systemic absorption of this propellant. Levels of HFA-134a between 200 and 700 ng.ml-1 were detected in all subjects given the CFC-free system. This study shows that acute inhalation of HFA-134a in a CFC-free system is as safe as a CFC propellant system. Salbutamol sulphate in the CFC-free system can be delivered in a dose-linear fashion, without any noticeable change in the safety profile of active drug.
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PMID:Acute safety of the CFC-free propellant HFA-134a from a pressurized metered dose inhaler. 858 66

A 20-year-old asthmatic woman who ingested 300 mg of salbutamol (Albuterol) and 30 g of paracetamol is presented. She had sinus tachycardia up to 160/min, hypotension (80/50 mmHg), tremor, hypokalemia (2.1 mEq/l) and hyperglycemia (12.1 mEq/l). Treatment was by gastric lavage, fluids, potassium and N-acetylcysteine. Symptoms resolved in 24 hours.
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PMID:[Salbutamol intoxication]. 915 36


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