Levalbuterol nebulizer solution: is it worth five times the cost of albuterol?

Abstract:

:Albuterol is a 50:50 mixture of R-albuterol, the active enantiomer, and S-albuterol, which appears to be inactive in humans. The Food and Drug Administration recently approved levalbuterol, the pure R-isomer, as a preservative-free nebulizer solution. Published studies indicate that it is neither safer nor more effective than an equimolar dose of racemic albuterol (levalbuterol 1.25 mg = albuterol 2.5 mg). However, these studies were conducted in patients with stable asthma (at the top of the dose-response curve), whereas a nebulized bronchodilator most likely would be used by patients with an acute exacerbation. Because such patients, in the hospital setting, often require higher doses of albuterol, the manufacturer's recommended dose of levalbuterol is likely to be too low for rescue therapy. Levalbuterol may cost as much as 5 times more than racemic albuterol, depending on purchase method. We conclude that levalbuterol offers no advantage over albuterol but is likely to be more costly.

journal_name

Pharmacotherapy

journal_title

Pharmacotherapy

authors

Asmus MJ,Hendeles L

doi

10.1592/phco.20.3.123.34776

subject

Has Abstract

pub_date

2000-02-01 00:00:00

pages

123-9

issue

2

eissn

0277-0008

issn

1875-9114

journal_volume

20

pub_type

杂志文章,评审
  • Tacrolimus Elimination in Four Patients With a CYP3A5*3/*3 CYP3A4*22/*22 Genotype Combination.

    abstract::Cytochrome P450 3A5 (CYP3A5) and cytochrome P450 3A4 (CYP3A4) are the predominate enzymes responsible for tacrolimus metabolism. The presence of CYP3A4 and CYP3A5 genetic variants significantly affects tacrolimus clearance and dose requirements. CYP3A5*3 is a loss-of-function variant resulting in no CYP3A5 enzyme prod...

    journal_title:Pharmacotherapy

    pub_type:

    doi:10.1002/phar.2131

    authors: Scheibner A,Remmel R,Schladt D,Oetting WS,Guan W,Wu B,Dorr C,Israni A,Jacobson PA

    更新日期:2018-07-01 00:00:00

  • A Randomized Noninferiority Trial of Intravenous Iron Isomaltoside versus Oral Iron Sulfate in Patients with Nonmyeloid Malignancies and Anemia Receiving Chemotherapy: The PROFOUND Trial.

    abstract:STUDY OBJECTIVE:A safe alternative to erythropoiesis-stimulating agents to treat anemia is warranted in patients with cancer and anemia; thus the objective of this trial was to compare the efficacy and safety of intravenous (IV) iron isomaltoside with oral iron in patients with cancer and anemia by testing the noninfer...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1002/phar.1729

    authors: Birgegård G,Henry D,Glaspy J,Chopra R,Thomsen LL,Auerbach M

    更新日期:2016-04-01 00:00:00

  • Torsades de pointes associated with fluoroquinolones.

    abstract::Recent attention has been called to the interpretation of studies of antiinfective agents demonstrating effects on the QTc interval. It seems that the effects of many of these agents on the QTc interval are small, but in some patient populations, these drugs may cause morbidity and mortality related to TdP. It would b...

    journal_title:Pharmacotherapy

    pub_type: 评论,杂志文章

    doi:10.1592/phco.22.8.663.33201

    authors: Owens RC Jr,Ambrose PG

    更新日期:2002-05-01 00:00:00

  • Etomidate: a new intravenous anesthetic induction agent.

    abstract::Currently available anesthetic induction agents provide adequate hypnosis but are not ideal, particularly in the high risk patient (ASA class III-V), because most cause myocardial and/or respiratory depression and some have other important side effects. Etomidate was recently marketed as an intravenous anesthetic indu...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1002/j.1875-9114.1983.tb03266.x

    authors: Giese JL,Stanley TH

    更新日期:1983-09-01 00:00:00

  • Clinical implications of vancomycin heteroresistant and intermediately susceptible Staphylococcus aureus.

    abstract::Staphylococcus aureus (S. aureus) has proven to be a major pathogen with the emergence of methicillin-resistant S. aureus (MRSA) infections and recently with heteroresistant vancomycin-intermediate S. aureus (hVISA) and vancomycin-intermediate S. aureus (VISA) infections. Although vancomycin is traditionally a first-l...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1002/phar.1577

    authors: Gomes DM,Ward KE,LaPlante KL

    更新日期:2015-04-01 00:00:00

  • Klebsiella pneumoniae carbapenemases in Enterobacteriaceae: history, evolution, and microbiology concerns.

    abstract::Since the discovery of penicillin 80 years ago, gram-negative bacteria have become proficient at evading the lethal activity of β-lactam antibiotics, principally through the production of β-lactamases. The rapid emergence of penicillinases in both gram-positive and gram-negative bacteria led to the development of ceph...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1002/j.1875-9114.2012.01035.x

    authors: Rapp RP,Urban C

    更新日期:2012-05-01 00:00:00

  • Argatroban therapy for antithrombin deficiency and mesenteric thrombosis: case report and review of the literature.

    abstract::Antithrombin deficiency is a hypercoagulable state that can increase the risk for thrombosis, especially in the presence of other procoagulant triggers. Unfractionated heparin and low-molecular-weight heparins may not provide effective anticoagulation since they require antithrombin for activity. Direct thrombin inhib...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1592/phco.24.6.659.34745

    authors: Dager WE,Gosselin RC,Owings JT

    更新日期:2004-05-01 00:00:00

  • Allopurinol for the Treatment of Refractory Aggression: A Case Series.

    abstract:OBJECTIVE:Allopurinol is a drug indicated for the treatment and prevention of gout. Through various theorized mechanisms, there has been an observed benefit in reducing aggression in patients with dementia who are refractory to traditional interventions. This case series of eight patients reports the use of allopurinol...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:10.1002/phar.1943

    authors: Carr CN,Straley CM,Baugh TB

    更新日期:2017-06-01 00:00:00

  • Association of GGH Promoter Methylation Levels with Methotrexate Concentrations in Chinese Children with Acute Lymphoblastic Leukemia.

    abstract:BACKGROUND:It is known that γ-glutamyl hydrolase (GGH) is involved in the disposition of methotrexate (MTX), and GGH activity is regulated by DNA methylation in acute lymphoblastic leukemia (ALL) cells. The present study explores the methylation status of the GGH promoter in peripheral blood and its association with MT...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:10.1002/phar.2430

    authors: Wang SM,Kong XY,Li M,Sun LL,Yan D

    更新日期:2020-07-01 00:00:00

  • Alteplase for Acute Ischemic Stroke after Heparin Reversal with Protamine: A Case Report and Review.

    abstract::Few patients presenting with acute ischemic stroke (AIS) are eligible for alteplase, especially those receiving ongoing anticoagulation. We describe the first reported case of a patient receiving full-dose intravenous (IV) alteplase for AIS after heparin reversal with protamine. A 73-year-old man presented with AIS. H...

    journal_title:Pharmacotherapy

    pub_type:

    doi:10.1002/phar.1997

    authors: Fontaine GV,Smith SM

    更新日期:2017-10-01 00:00:00

  • Zidovudine pharmacokinetics in five HIV seronegative patients undergoing continuous ambulatory peritoneal dialysis.

    abstract::A few reports in the literature describe zidovudine (AZT) pharmacokinetics in patients undergoing hemodialysis; however, the effect of continuous ambulatory peritoneal dialysis (CAPD) on the drug's disposition has not been studied. The pharmacokinetics of AZT were evaluated in five patients, age 37-62 years, who were ...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:

    authors: Kremer D,Munar MY,Kohlhepp SJ,Swan SK,Stinnett EA,Gilbert DN,Young EW,Bennett WM

    更新日期:1992-01-01 00:00:00

  • Low-molecular-weight heparin in transesophageal echocardiography-guided cardioversion of atrial fibrillation.

    abstract::Atrial fibrillation is the most common sustained cardiac arrhythmia and is associated with thromboembolic events and hemodynamic impairment that results in considerable morbidity, mortality, and cost. Cardioversion to sinus rhythm is a common approach to the treatment of these patients. However, cardioversion is assoc...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1592/phco.23.1.57.31917

    authors: Wodlinger AM,Pieper JA

    更新日期:2003-01-01 00:00:00

  • Glycemic Management in the Bariatric Surgery Population: A Review of the Literature.

    abstract::Obesity is a worldwide epidemic often complicated by multiple comorbidities, including type 2 diabetes mellitus (T2DM). Bariatric surgery is an increasingly common and effective weight-loss strategy for obese patients that may result in resolution of metabolic-related disease states, such as T2DM. Although bariatric s...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1002/phar.2120

    authors: Howard ML,Steuber TD,Nisly SA

    更新日期:2018-06-01 00:00:00

  • Pharmacokinetics of palifermin administered as the standard dose and as a collapsed dose in patients with hematologic malignancies.

    abstract:STUDY OBJECTIVE:To assess the pharmacokinetic profile of palifermin after intravenous dosing with either a collapsed dose of 180 microg/kg/day for 1 day or a standard dose of 60 microg/kg/day for 3 days, before and after myeloablative chemoradiotherapy and peripheral blood progenitor cell (PBPC) transplantation. DESIG...

    journal_title:Pharmacotherapy

    pub_type: 临床试验,杂志文章

    doi:10.1592/phco.27.10.1353

    authors: Zia-Amirhosseini P,Hurd DD,Salfi M,Cheah TC,Aycock J,Cesano A

    更新日期:2007-10-01 00:00:00

  • Frequency and severity of harm of medication errors related to the parenteral nutrition process in a large university teaching hospital.

    abstract:STUDY OBJECTIVE:To determine the frequency of medication errors, as well as the severity of harm resulting from these errors, related to the prescription, transcription, preparation, and administration of parenteral nutrition formulations. DESIGN:Prospective, observational study. SETTING:471-bed, academic teaching ho...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:10.1592/phco.29.8.966

    authors: Sacks GS,Rough S,Kudsk KA

    更新日期:2009-08-01 00:00:00

  • The effect of Cys LT1 receptor blockade on airway responses to allergen.

    abstract:STUDY OBJECTIVE:To evaluate the effect of a potent experimental leukotriene receptor antagonist, MK-571, on airway responses to inhaled allergen. DESIGN:Randomized, double-blind, placebo-controlled, crossover trial. SETTING:Clinical research center. SUBJECTS:Eight male volunteers with allergic asthma. INTERVENTIONS...

    journal_title:Pharmacotherapy

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1592/phco.19.16.1243.30878

    authors: Hendeles L,Davison D,Harman E,Sherman JM

    更新日期:1999-11-01 00:00:00

  • Ziconotide infusion for severe chronic pain: case series of patients with neuropathic pain.

    abstract::Ziconotide intrathecal infusion was recently approved by the United States Food and Drug Administration for the treatment of intractable severe chronic pain. Patients with neuropathic pain make up a significant population among those who experience chronic pain for which there are less than optimal pharmacotherapeutic...

    journal_title:Pharmacotherapy

    pub_type: 临床试验,杂志文章

    doi:10.1592/phco.26.3.395

    authors: Wermeling DP,Berger JR

    更新日期:2006-03-01 00:00:00

  • Diflunisal in the treatment of the pain of osteoarthritis. Summary of clinical studies.

    abstract::In comprehensive clinical studies, diflunisal--a new nonsteroidal antiinflammatory drug with a long duration of action--was shown to be highly effective and generally well tolerated in the short- and long-term treatment of the pain of osteoarthritis. In double-blind comparison studies, diflunisal was comparable in eff...

    journal_title:Pharmacotherapy

    pub_type: 临床试验,杂志文章

    doi:

    authors: Umbenhauer ER

    更新日期:1983-03-01 00:00:00

  • Paclitaxel (taxol).

    abstract::Paclitaxel is a novel antineoplastic that effects cytotoxicity by promoting intracellular tubulin polymerization and stabilizes abnormal microtubule structures against depolymerization. Although its clinical development had been hampered by misconceptions about its pharmacology, its scarcity, difficulties extracting i...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1002/j.1875-9114.1994.tb02785.x

    authors: Kohler DR,Goldspiel BR

    更新日期:1994-01-01 00:00:00

  • Pharmacodynamic Effects of Low-Dose Pioglitazone in Patients with the Metabolic Syndrome without Diabetes Mellitus.

    abstract:STUDY OBJECTIVE:To determine the effects of low-dose pioglitazone on plasma adipocyte-derived cytokines, high-sensitivity C-reactive protein (hs-CRP), and components of the metabolic syndrome in adults with the metabolic syndrome without diabetes mellitus. DESIGN:Prospective, randomized, double-blind, placebo-controll...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章,随机对照试验

    doi:10.1002/phar.1713

    authors: Vu A,Kosmiski LA,Beitelshees AL,Prigeon R,Sidhom MS,Bredbeck B,Predhomme J,Deininger KM,Aquilante CL

    更新日期:2016-03-01 00:00:00

  • Fluconazole-induced agranulocytosis with eosinophilia.

    abstract::Fluconazole is a commonly prescribed antifungal agent with a favorable safety profile. A patient experienced agranulocytosis and eosinophilia associated with the drug. Similar bone marrow-suppressive effect due to the azoles is rarely described in the English-language literature. ...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:10.1592/phco.20.5.484.35058

    authors: Wong-Beringer A,Shriner K

    更新日期:2000-04-01 00:00:00

  • Does the addition of pindolol accelerate or enhance the response to selective serotonin reuptake inhibitor antidepressants?

    abstract::Although in the last few years new antidepressants have become available in the United States, responses in many patients differ, from none, to partial, to delayed therapeutic response to the agents. If the antidepressant properties of these drugs could be enhanced or accelerated, it might be possible to improve patie...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1592/phco.19.3.205.30921

    authors: Puzantian T,Kawase K

    更新日期:1999-02-01 00:00:00

  • Pharmacokinetics of intranasal and intratracheal pentoxifylline in rabbits.

    abstract:STUDY OBJECTIVE:To evaluate the disposition of pentoxifylline and its metabolite, lisofylline, in New Zealand rabbits after two alternative routes of administration, intranasal and intratracheal. DESIGN:Pharmacokinetics study in an animal model. SETTING:University-affiliated animal care facility. SUBJECTS:Twenty New...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:10.1592/phco.27.2.200

    authors: Adcock KG,Kyle PB,Deaton JS,Olivier JH,Hogan SM

    更新日期:2007-02-01 00:00:00

  • Prevention of Clostridium difficile Infection in Critically Ill Adults.

    abstract::The incidence and severity of Clostridium difficile infection (CDI) remain high across intensive care units in the United States despite national efforts to decrease this escalating health care burden. Most published literature and guidelines address treatment rather than prevention, yet this approach may be too downs...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1002/phar.2200

    authors: Leedahl DD,Personett HA,Nagpal A,Barreto EF

    更新日期:2019-03-01 00:00:00

  • Nabilone for the Management of Pain.

    abstract::Nabilone, a synthetic cannabinoid, is approved in many countries including, but not limited to, Canada, the United States, Mexico, and the United Kingdom for the treatment of severe nausea and vomiting associated with chemotherapy. Clinical evidence is emerging for its use in managing pain conditions with different et...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1002/phar.1709

    authors: Tsang CC,Giudice MG

    更新日期:2016-03-01 00:00:00

  • Renal function and methotrexate clearance in children with newly diagnosed leukemia.

    abstract:STUDY OBJECTIVES:To determine whether glomerular filtration rate (GFR) changes during induction chemotherapy in children with leukemia, and to examine GFR as a determinant of pharmacokinetic variability of methotrexate clearance. DESIGN:Prospective, unblinded observational study in consecutive patients. SETTING:A res...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:

    authors: Murry DJ,Synold TW,Pui CH,Rodman JH

    更新日期:1995-03-01 00:00:00

  • Asian and Asian-American college students' awareness of osteoporosis.

    abstract:STUDY OBJECTIVE:To quantify Asian and Asian-American college students' knowledge of osteoporosis and preventive health behaviors. DESIGN:Sixty-four-question survey SETTING:University of Minnesota. SUBJECTS:One hundred sixty-eight male and female Asian and Asian-American students, mean age 21 +/- 3.4 years. MAIN RES...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:10.1592/phco.22.12.1047.33608

    authors: Nguyen DN,O'Connell MB

    更新日期:2002-08-01 00:00:00

  • Evaluation of the half-life of intravenous human cytomegalovirus immune globulin in patients receiving partially mismatched related donor bone marrow transplantation.

    abstract:STUDY OBJECTIVE:To evaluate the pharmacokinetics and use of intravenous human cytomegalovirus immune globulin (CytoGam) in allogeneic bone marrow transplantation (BMT). DESIGN:Prospective, nonrandomized, nonblinded, single-center study. SETTING:University teaching hospital. PATIENTS:Five consecutive patients with he...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:10.1592/phco.20.15.1175.34592

    authors: DeRienzo SY,Chiang KY,O'Neal WM,Godder K,Abhyankar S,Christiansen NP,Bridges KD,Henslee-Downey PJ

    更新日期:2000-10-01 00:00:00

  • Comparing the bispectral index and suppression ratio with burst suppression of the electroencephalogram during pentobarbital infusions in adult intensive care patients.

    abstract:OBJECTIVE:The bispectral index (BIS), a processed variable derived from the raw electroencephalogram (EEG) used to guide sedation in the intensive care unit (ICU), has not been tested during barbiturate therapy for elevated intracranial pressure. We determined the BIS and suppression ratio (SR) values during traditiona...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:10.1592/phco.23.10.1087.32766

    authors: Riker RR,Fraser GL,Wilkins ML

    更新日期:2003-09-01 00:00:00

  • The effect of food on bromfenac, naproxen sodium, and acetaminophen in postoperative pain after orthopedic surgery.

    abstract:STUDY OBJECTIVES:To evaluate the effect of a standard meal on bioavailability of bromfenac, and on the relative analgesic efficacy and adverse effect liability of bromfenac 25 mg, naproxen sodium 550 mg, and acetaminophen 325 mg in the treatment of pain after orthopedic surgery. DESIGN:Randomized, double-blind, single...

    journal_title:Pharmacotherapy

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Forbes JA,Sandberg RA,Bood-Björklund L

    更新日期:1998-05-01 00:00:00