Albuterol vs. Levalbuterol: The Preferred Treatment for Asthma

1116 Words3 Pages

Introduction

Asthma is a chronic inflammatory disease of the airways. It is a reversible airway obstruction, occurring 8 to 10% of the population worldwide. According to a study in 2005, asthma affects over 15 million Americans, with more than 2 million annual emergency room visits. Asthma patients have a hyper-responsiveness in their airways and generally and increase in their airway smooth muscle cell mass. This hyperplasia is due to the normal response to the injury and repair to the airway caused by exacerbations. The main choice of therapy for asthma patients is β2- adrenergic agonists. Racemic albuterol has been the drug of choice for a short acting bronchodilator for a long time, but since the development of levalbuterol, there is the question of which drug is a better choice for therapy. Efficacy and cost of treatment must both be taken into consideration in each study of these therapies to determine which is best for the treatment of asthma.

Overview

Racemic albuterol is a β2- adrenergic agonist that is a 50:50 mixture of two isomers, (R) albuterol and (S) albuterol. These two isomers are mirror images of each other, and rotate light in opposite directions. (R) Albuterol is an active isomer and in this combination acts an active bronchodilator. The other half of the mixture, (S) albuterol, does not actually possess any bronchodilator activity and was until recently considered an “inactive” distomer or physiologically inert. The “R” stands for rectus or right, while the “S” is for sinister or left. Racemic albuterol was synthesized for maximal airway smooth muscle dilation while minimizing the α- and β1-receptor mediated effects on the cardiovascular system. Levalbuterol is the single (R)-isomer and has a...

... middle of paper ...

...ospitalized at a total cost of $600,000. The difference of $400,000 saved by treating with levalbuterol makes the extra $5000 spent on the drug seem much less in comparison.

Works Cited

Ameredes, B. T., & Calhoun, W. J. (2009). Levalbuterol versus albuterol. Current Allergy and Asthma Reports , 401-409.

Ibe, B. O., Portugal, A. M., & Raj, J. U. (2006). Levalbuterol inhibits human airway smooth muscle cell proliferation: Therapeutic implications in the management of asthma. International Archives of Allergy and Immunology , 225-236.

Schreck, D. M., & Babin, S. (2005). Comparison of racemic albuterol and levalbuterol in the treatment of acute asthma in the ed. American Journal of Emergency Medicine , 842-847.

Truitt, T. W. (2003). Levalbuterol compared to racemic albuterol: Efficacy and outcomes in patients hospitalized with COPD or asthma. Chest , 128-135.

More about Albuterol vs. Levalbuterol: The Preferred Treatment for Asthma

Open Document