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April 28, 1978

Sustained Effectiveness of Terbutaline

Author Affiliations

The Milton S. Hershey Medical Center The Pennsylvania State University Hershey

JAMA. 1978;239(17):1744. doi:10.1001/jama.1978.03280440028011

To the Editor.—  We read Backus and Snider's article on the "Bronchodilator Effects of Aerosolized Terbutaline: A Controlled, Double-Blind Study" (238:2277, 1977). It was not surprising that he found a statistically significant difference both in duration and in intensity of response as compared with placebo and isoproterenol.One statement in his discussion, however, calls for comment. The author states that two questions need to be answered before aerosol terbutaline should be used for maintenance therapy. The first is "whether tachyphylaxis develops with routine daily use." We1 looked at 24 stable ambulant patients with reversible airways disease who were given aerosolized terbutaline at a dose of 0.375 mg and were instructed to use their inhaler as usual. They were retested at day 1,14, 28, and 42 by the measurement of forced expiratory volume for one second and maximal expiratory flow rate and heart rate. Twenty-two of the 24 patients completed