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Editorials |

The Expanding Role of Long-Acting β-Agonists

James F. Donohue, MD, FCCP
Author and Funding Information

Affiliations: Chapel Hill, NC 
 ,  Dr. Donohue has research contracts and is on the Speakers’ Bureau for Glaxo Wellcome, the manufacturer of salmeterol. Dr. Donohue is Professor of Medicine, Division of Pulmonary and Critical Care Medicine, University of North Carolina School of Medicine, Chapel Hill, NC.

Correspondence to: James F. Donohue, MD, FCCP, Department of Medicine, CB#7020, 420 Burnett-Womack Building, Chapel Hill, NC 27599-7020; e-mail: jdonohue@med.unc.edu



Chest. 2000;118(2):283-285. doi:10.1378/chest.118.2.283
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The long-acting β2-agonist salmeterol has been approved for chronic maintenance therapy in asthma1 and COPD.2 Previous studies were conducted on outpatients who were well controlled with no comorbidity factors. Because of its relative slow onset of action, salmeterol is not indicated for relief of acute bronchospasm. However, exposure to this agent is unavoidable in the acute setting where, in fact, salmeterol may have unique benefits and risks. Clinicians need more information on the use of this agent in relevant settings such as the emergency department, ICU, medical and pediatric wards, operating room, and labor and delivery suites. Hospitalized patients are often acutely ill, and may be receiving large doses of concurrent medications such as short-acting β-agonists, theophylline, corticosteroids, anesthetics, and analgesics. Furthermore, patients may be under physiologic stresses, such as pregnancy or surgery. Data on the safety of salmeterol in the hospital setting are slowly being compiled; information on benefits such as decreased length of stay, decreased costs, and improved clinical outcomes are not yet available. A number of issues concerning the use of salmeterol in the hospital are raised:

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