Levosalbutamol versus Salbutamol for Treatment of Acute Exacerbation of Asthma in Bangladesh Children

Introduction: Salbutamol is an effective treatment of acute exacerbation asthma but its use is associated with undesirable side effects like tachycardia and hypokalemia. Published studies have showed that levosalbutamol improves pulmonary function more than racemic salbutamol without the known salbutamol side effects. Objective: To compare the efficacy and tolerability of Levosalbutamol and Salbutamol for the treatment of acute exacerbation of asthma in Bangladesh children aged 8 to 15 years. Methods: A randomized double blind clinical study included 60 known asthmatic children aged between 8 and 15 years, who attended the emergency department for an acute exacerbation. The studied medicines were salbutamol 2.5 mg and levosalbutamol 0.63 mg. The total drug volume was 2.5 ml which was nebulized over a period of 8-10 minutes. Forced expiratory volume in 1st second was measured using Manual Promoter. Spirometry was performed 3 times and the best of the three values was recorded. The following clinical parameters were recorded initially and after giving 3 nebulizations at 20 minutes interval in the 1st hour of presentation: respiratory rate (RR), heart rate (HR), oxygen saturation in room air SPO2, FEV1 (forced expiratory volume in 1 st second), asthma score and serum potassium level. Results: In the levosalbutamol group there was significant increment in FEV1 and SpO2 (p<0.05) with decreased tachypnea and asthma score while no significant difference was found in the pre and post treatment HR and serum K+ levels. In the Salbutamol group although there was clinical improvement in terms of FEV1, SpO2 and asthma score, there was significant tachycardia and decrease in K+ levels. Conclusion: Levosalbutamol has similar therapeutic effects with salbutamol in acute exacerbation of asthma but has no side effects such as tachycardia and hypokalemia. Journal of Allergy & Therapy J ou na l o f Allergy & Thrapy