PEDIATRICS Vol. 90 No. 4 October 1992, pp. 639-640
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The Proper Role of beta2-Adrenergic Agonists in the Treatment of Children with Asthma

CLIFTON T. FURUKAWA MD, FAAP1, JAMES P. KEMP MD, FAAP2, F. ESTELLE R. SIMONS MD, FAAP3, and DAVID C. TINKELMAN MD, FAAP4

1 4540 Sand Point Way NE, Seattle, Washington 98105
2 344 Kearny Villar Road, San Diego, California 92123
3 Department of Pediatrics and Child Health, University of Manitoba Children's Hospital of Winnipeg Winnipeg, Manitoba R3A 1S1 Canada
4 6667 Vernon Woods Drive Atlanta, Georgia 30328-3279

beta-Adrenergic agonist therapy was associated with increased asthma mortality when high-potency isoproterenol was used in the United Kingdom in the 1960s, and when the beta-agonist fenoterol was used increasingly in New Zealand in the 1970s.1-3 Recently, a Canadian epidemiologic study reported an increased risk of death with regular use of beta-agonists, particularly fenoterol.4 Fenoterol may be uniquely less safe than other beta-agonists because of a greater cardiotoxic potential due to less beta2 specificity (than terbutaline) and a greater relative dose per actuation.5 The concerns about the safety of beta-agonists are linked intimately with the concerns about their effectiveness in asthma therapy.

Submitted on April 6, 1992
Accepted on April 8, 1992