Asthma Articles
Evidence-based articles about asthma from certified pharmacists
Salbutamol vs Levosalbutamol: What the Enantiomer Evidence Actually Shows
Levosalbutamol is purified (R)-salbutamol, and the argument for it is real chemistry: the (S) isomer has minimal beta-2 activity and is cleared up to 12 times more slowly. Two double-blind paediatric trials found better peak flow and oxygen saturation with less tachycardia. But the trials are small, one key adult study was open-label, and guidelines still treat the two as equivalent options. Here is both sides with the numbers.
Budesonide with Formoterol Inhalers: Doses, MART and What the Trials Show
Budesonide with formoterol is the only inhaled steroid and long-acting beta agonist combination that can serve as both preventer and reliever. SYGMA 1 cut severe exacerbations from 0.20 to 0.07 per year on 17 percent of the steroid dose, and the CARE trial in children reported 0.23 versus 0.41 attacks per year against salbutamol. This guide covers the trial numbers, strength conventions across Foracort and Symbicort, device choice and where the combination is the wrong answer.
Montelukast Side Effects: What the Trial Data and the Boxed Warning Actually Say
Montelukast trial data and boxed warning read very differently. In placebo-controlled trials the adverse reaction rates were nearly identical to placebo, with headache at 18.4 percent versus 18.1 percent on placebo. The 2020 FDA boxed warning came from post-marketing reports instead. This guide separates the two, with the full Table 1 rates, the psychiatric reports list, paediatric data and dosing by age.
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