Aerosol vs injected epinephrine in acute asthma.

ABSTRACT

Twenty-five patients with acute asthma were randomized prospectively into one of two double-blind treatment regimens regimen 1 consisted of subcutaneous epinephrine combined with aerosol placebo; regimen 2 consisted of aerosol epinephrine with injected placebo. In patients with severe airway obstruction (peak expiratory flow rate less than 120, or less than 25% of predicted normal), parenteral epinephrine was superior to aerosol (P less than 0.005) at the end of one hour. However, in patients with mild to moderate asthma (PEFR greater than 120), injected and inhaled epinephrine were of equal efficacy, with the aerosol producing fewer side effects (P less than 0.001).