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April 25, 1980

Treatment of Asthma

Author Affiliations

Wayne State University School of Medicine Veterans Administration Medical Center Allen Park, Mich

JAMA. 1980;243(16):1630. doi:10.1001/jama.1980.03300420014009

To the Editor.—  In view of the recent interest in theophylline pharmacokinetics and β2-adrenergic agents, the article by Josephson et al (242:639, 1979) was a refreshing reminder of the efficacy of epinephrine in the treatment of acute asthma. Apparently, all subjects experienced improvement in the peak expiratory flow rates (PEF), although only group mean values and SDs were presented. Presumably, the clinical response was directly related to the PEF. Ultimately, 75% of subjects were discharged after 90 minutes; 22% were discharged within 12 hours; and only 3% required admission.Unfortunately, the authors did not relate the criteria used in determining the discharge or admission of subjects. The data provided indicate that only 2.5% of subjects showed greater than 70% of their predicted PEFs during the study. Most subjects failed to improve their PEFs to 60% of predicted values. Thus, the majority of subjects seem to have been discharged