Acute response to bronchodilator. An imperfect guide for bronchodilator therapy in chronic airflow limitation

Arch Intern Med. 1988 Sep;148(9):1949-52. doi: 10.1001/archinte.148.9.1949.


We conducted a four-period cross-over randomized trial in which we found that patients with chronic airflow limitation demonstrated symptomatic improvement with both inhaled albuterol and oral theophylline. The response, however, was not uniform. We therefore tested the ability of acute change in forced expired volume in one second (FEV1) following inhaled beta agonist to predict long-term symptomatic response to albuterol and theophylline. We found that the reproducibility of acute change in FEV1 over three repetitions was poor (intraclass correlation 0.17). Furthermore, the mean improvement FEV1 following inhaled albuterol across the three repetitions did not relate closely to symptomatic response to either albuterol or theophylline. We conclude that acute response to inhaled beta agonist is not useful for identifying patients with chronic airflow limitation who are likely to benefit from bronchodilator treatment.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Administration, Oral
  • Aged
  • Albuterol / administration & dosage
  • Albuterol / therapeutic use*
  • Analysis of Variance
  • Clinical Trials as Topic
  • Dyspnea / etiology
  • Dyspnea / physiopathology
  • Female
  • Forced Expiratory Volume
  • Humans
  • Lung Diseases, Obstructive / complications
  • Lung Diseases, Obstructive / drug therapy*
  • Lung Diseases, Obstructive / physiopathology
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Random Allocation
  • Theophylline / administration & dosage
  • Theophylline / therapeutic use*
  • Time Factors
  • Vital Capacity / drug effects


  • Theophylline
  • Albuterol