Abstract
β-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 β-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 β-agonists, particularly fenoterol.4 Fenoterol may be uniquely less safe than other β-agonists because of a greater cardiotoxic potential due to less β2 specificity (than terbutaline) and a greater relative dose per actuation.5 The concerns about the safety of β-agonists are linked intimately with the concerns about their effectiveness in asthma therapy.
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