Terbutaline accumulates in blood and urine following daily therapeutic inhalation

TY - JOUR

T1 - Terbutaline accumulates in blood and urine following daily therapeutic inhalation

AU - Krogh, Nanna

AU - Rzeppa, Sebastian

AU - Dyreborg, Anders

AU - Dehnes, Yvette

AU - Hemmersbach, Peter

AU - Backer, Vibeke

AU - Hostrup, Morten

N1 - CURIS 2017 NEXS 141

PY - 2017

Y1 - 2017

N2 - Purpose: This study investigated pharmacokinetics of terbutaline after single and seven consecutive days of inhalation in exercising trained men. Methods: Twelve healthy trained men underwent two pharmacokinetic trials comparing single dose (2 mg) and seven consecutive days (2 mgIdj1) of inhaled terbutaline. After inhalation of terbutaline at each trial, subjects performed 90 min of bike ergometer exercise at 55%-65% of maximal oxygen consumption after which they stayed inactive. Blood and urine samples were collected before and after inhalation of terbutaline. Samples were analyzed by high-performance liquid chromatography-tandem mass spectrometry. Results: Maximum serum concentration of terbutaline (Cmax) (6.4 T 1.2 vs 4.9 T 1.2 ngImLj1, P = 0.01) (mean T 95% confidence interval) and area under serum concentration-time curve from 0 to 4 h after inhalation (AUC0-4) (16 T 3 vs 13 T 2 ngImLj1Ihj1, P e 0.005) were higher after 7 d of inhalation compared with the first day. Seven days of terbutaline inhalation resulted in accumulation of terbutaline in urine, in which total urine excretion of terbutaline was higher after 7 d of inhalation compared with the first day (274 T 43 vs 194 T 33 Kg, P e 0.001). These differences were partly attributed to systemic accumulation of terbutaline after consecutive days of inhalation, in that baseline serum and urine samples revealed incomplete elimination of terbutaline. Conclusion: Terbutaline accumulates in serum and urine after consecutive days of inhalation. For doping control purposes, these observations are of relevance if a urine threshold and decision limit is to be introduced for terbutaline on the World Anti-Doping Agency's list of prohibited substances because asthmatic athletes may use their bronchorelievers for consecutive days.

AB - Purpose: This study investigated pharmacokinetics of terbutaline after single and seven consecutive days of inhalation in exercising trained men. Methods: Twelve healthy trained men underwent two pharmacokinetic trials comparing single dose (2 mg) and seven consecutive days (2 mgIdj1) of inhaled terbutaline. After inhalation of terbutaline at each trial, subjects performed 90 min of bike ergometer exercise at 55%-65% of maximal oxygen consumption after which they stayed inactive. Blood and urine samples were collected before and after inhalation of terbutaline. Samples were analyzed by high-performance liquid chromatography-tandem mass spectrometry. Results: Maximum serum concentration of terbutaline (Cmax) (6.4 T 1.2 vs 4.9 T 1.2 ngImLj1, P = 0.01) (mean T 95% confidence interval) and area under serum concentration-time curve from 0 to 4 h after inhalation (AUC0-4) (16 T 3 vs 13 T 2 ngImLj1Ihj1, P e 0.005) were higher after 7 d of inhalation compared with the first day. Seven days of terbutaline inhalation resulted in accumulation of terbutaline in urine, in which total urine excretion of terbutaline was higher after 7 d of inhalation compared with the first day (274 T 43 vs 194 T 33 Kg, P e 0.001). These differences were partly attributed to systemic accumulation of terbutaline after consecutive days of inhalation, in that baseline serum and urine samples revealed incomplete elimination of terbutaline. Conclusion: Terbutaline accumulates in serum and urine after consecutive days of inhalation. For doping control purposes, these observations are of relevance if a urine threshold and decision limit is to be introduced for terbutaline on the World Anti-Doping Agency's list of prohibited substances because asthmatic athletes may use their bronchorelievers for consecutive days.

KW - Faculty of Science

KW - Beta2-agonist

KW - Asthma

KW - Sports

KW - WADA

KW - HPLC

U2 - 10.1249/MSS.0000000000001199

DO - 10.1249/MSS.0000000000001199

M3 - Journal article

C2 - 28072631

SN - 0195-9131

VL - 49

SP - 1236

EP - 1243

JO - Medicine and Science in Sports and Exercise

JF - Medicine and Science in Sports and Exercise

IS - 6

ER -