Effects of nebulised beta-2 agonists on clinical observations in asthma exacerbations

Mortimer, Craig, Nikoletou, Dimitra, Ooms, Ann and williams, Julia (2023) Effects of nebulised beta-2 agonists on clinical observations in asthma exacerbations. Journal of Paramedic Practice, 15(2), pp. 1-11. ISSN (print) 1759-1376


Background: Despite concerns over their resultant side effects short-acting β₂ agonists are still used in high doses internationally in prehospital care delivery to treat asthma exacerbations. This systematic review set out to identify the physiological effects associated with this treatment and determine their potential impact on the patient’s presenting or underlying conditions. Methods: A systematic search of literature published from 2010 to 2020 and focusing on asthmatic patients receiving nebulised β₂ agonists during an acute exacerbation was undertaken with relevant articles reviewed. Findings: Eight out of 897 studies met the inclusion criteria. Despite being heterogeneous with ranging outcome measures, synthesis showed evidence of bronchodilator action throughout, with reductions in potassium levels and cardiovascular changes reported across several studies. Conclusions: Therapeutic effects demonstrated within the data support the use of nebulised β₂ agonists in these patients, and whilst adverse effects are frequently seen in the cardiovascular and endocrine systems, their impact on the patient’s overall condition remains unclear.

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