Use of adrenergic bronchodilators by pediatric allergists and pulmonologists
R. W. Newcomb
Pediatric Allergy and Pulmonology Service, Merrillville, IN 46410.
Twenty-one pediatricians specializing in allergy, pulmonology, or both were
questioned about their use of adrenergic bronchodilators for treating
children of different ages at home, in the emergency department, and in the
hospital. Most would use inhaled medications in all settings and for all
ages. Few expressed strong preference for one drug over another, but only 2
would regularly use nebulized isoproterenol hydrochloride or isoetharine
hydrochloride. Dosing frequency of inhaled medication at home was usually
limited to every 4 hours, but in the emergency department or hospital,
intervals between doses of 20 minutes or less were common. If this
treatment failed, 9 physicians would use intravenous isoproterenol, but 4
strongly opposed its use. These results indicate that substantial variation
exists in current expert practice, but that inhaled albuterol,
metaproterenol, or terbutaline sulfate are most often preferred for
treating asthma, bronchopulmonary dysplasia, and bronchiolitis in children
of all ages, and that doses and dosing intervals are frequently altered to
meet patient needs.
