Pulmonary response to a bronchodilator delivered by three inhalation methods on exercise-induced bronchospasm

We compared the pulmonary response to beta2 agonists by using three inhalation methods: a jet nebulizer, a conventional metered dose of inhaler (MDI), and an MDI plus spacer. Nine subjects with moderate to severe asthma (mean age 10.6 years), who showed a ≥ 15% decrease in FEV1 and ≥ 30% decrease in ṿ25 after a standardized exercise test, were studied. The exercise task was performed on a treadmill at a speed of 6.5 km/hour at a 10% incline for 6 minutes. After the finished exercise-induced bronchospasms (EIB), orciprenaline sulfate [Arotec, 4 mg (0.2 ml)] for the jet nebulizer or 7.5 mg (1 puff) for the MDI or the MDI plus spacer was inhaled by one of the three different methods. Spirometry was performed before and 5, 15, 30, 60, and 90 minutes after the exercise. The mean decrease after 5 minutes exercise in FEV1 was 51.9% without inhalation, 22.2% with a jet nebulizer, 23.7% with an MDI, and 10.1% with an MDI plus spacer. These data suggested that the use of a spacer permits effective delivery of a bro...