Terbutaline vs albuterol for out-of-hospital respiratory distress: randomized, double-blind trial

Acad Emerg Med. 1995 Aug;2(8):686-91. doi: 10.1111/j.1553-2712.1995.tb03619.x.


Objective: To determine the efficacy and safety of single doses of subcutaneous terbutaline (TERB) or nebulized albuterol (ALB) during out-of-hospital treatment for respiratory distress from asthma or chronic obstructive pulmonary disease.

Methods: Patients aged > 18 years who had respiratory distress were enrolled in a double-placebo, double-blind, randomized trial. Paramedics measured respiratory severity using an empiric score [respiratory rate, wheezing, speech, and peak expiratory flow rate (PEFR)], and the patients rated their own respiratory distress using a visual analog scale (VAS). The patients received O2 plus ALB (2.5 mg) and saline injection (n = 40) or TERB (0.25 mg) and saline aerosol (n = 43).

Results: The groups were similar with respect to age, gender, initial empiric scores (median score 9 for both groups), PEFRs (89 +/- 84 L/min, mean +/- SD, for ALB vs 97 +/- 84 L/min for TERB), and respiratory distress VAS scores. Both groups showed significant improvement in their respiratory distress VAS scores by the time of ED arrival. The ALB group had a greater improvement in respiratory distress VAS score than did the TERB group (p < 0.05). Empiric scores, PEFR scores, and hospital admission frequencies were not significantly different. No complication was observed.

Conclusion: The out-of-hospital administration of either aerosolized ALB or subcutaneous TERB reduced respiratory severity. Albuterol provided greater subjective improvement in respiratory distress.

Publication types

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

MeSH terms

  • Administration, Inhalation
  • Adult
  • Aged
  • Albuterol / therapeutic use*
  • Bronchodilator Agents / therapeutic use*
  • Double-Blind Method
  • Dyspnea / drug therapy*
  • Dyspnea / etiology
  • Emergency Medical Services / methods*
  • Female
  • Humans
  • Injections, Subcutaneous
  • Lung Diseases, Obstructive / complications*
  • Male
  • Middle Aged
  • Peak Expiratory Flow Rate / drug effects
  • Prospective Studies
  • Severity of Illness Index
  • Terbutaline / therapeutic use*


  • Bronchodilator Agents
  • Terbutaline
  • Albuterol