levalbuterol / Generic mfg. - LARVOL DELTA

Utility of inhaled β2-agonists in reducing serum potassium levels in adult patients with hyperkalemia: A scoping review. (PubMed, PLoS One) - "Inhaled β2-agonists, particularly nebulized salbutamol, represent an effective and safe therapeutic option for the acute reduction of serum potassium in adults with hyperkalemia. Their rapid onset of action and applicability across various patient profiles make them a valuable tool in emergency settings, especially where immediate access to advanced therapies such as dialysis is limited. Further research is warranted to evaluate long-term outcomes, safety in patients with cardiovascular comorbidities, and optimal dosing strategies."

Journal • Cardiovascular • Chronic Kidney Disease • Diabetes • Nephrology • Renal Disease

Assessing the cardiovascular and potassium lowering effects of levalbuterol compared to albuterol: a randomized control trial. (PubMed, Front Cardiovasc Med) - P4 | "Both medications showed similar patterns in heart rate changes, potassium levels, and blood pressure variations at different time points. Clinicaltrials.gov, identifier NCT05173584."

Clinical • Journal • Cardiovascular • Congestive Heart Failure • Heart Failure • Movement Disorders

A 10-year interval of cardiovascular effects of albuterol in asthma management: Graphical review. (PubMed, Curr Res Pharmacol Drug Discov) - "The review highlights the importance of risk stratification, personalized dosing, and enhanced monitoring, particularly in high-risk groups, to maximize the therapeutic benefits of SABAs while minimizing cardiovascular harm. Overall, the findings underscore the need for ongoing pharmacovigilance and tailored clinical decision-making when prescribing albuterol in asthma care."

Journal • Review • Asthma • Cardiovascular • Hypotension • Immunology • Pediatrics • Pulmonary Disease • Respiratory Diseases

A Curious Case Of Severe Asthma (ACAAI 2025) - "Despite compliance with Fluticasone propionate/Salmeterol 500/50 mcg, Tiotoprium 2.5 mcg, she was using her Levalbuterol MDI daily...Six weeks later, she reported that her exercise tolerance and dyspnea were significantly improved after a week of treatment with Apixaban. She had not needed her Levalbuterol inhaler since her last appointment. Discussion It is important to consider alternative diagnoses and a patient’s medical history when asthma is not well-controlled, especially when one has unique symptoms and is not responding to traditional asthma medications."

Clinical • Allergic Rhinitis • Asthma • Cardiovascular • Immunology • Inflammation • Pulmonary Disease • Pulmonary Embolism • Respiratory Diseases

Combination Short-Acting Bronchodilator and Inhaled Corticosteroid Rescue Therapy (the ANCHOR Study): Rationale and Design (ACAAI 2025) - "Results/Conclusions ANCHOR evaluates the changes in annualized asthma exacerbation rates after switching rescue therapy to a single albuterol plus budesonide inhaler among participants with asthma using health insurance claims data. The unique study model with minimal intervention and utilizing real-world claims data enables researchers to understand treatment patterns and drug effectiveness in the real-world setting."

Asthma • Immunology • Respiratory Diseases

Marshmallow Mutton Monistat Oh My Goat! Food-Dependent Exercise-Induced Anaphylaxis to Gelatin (ACAAI 2025) - "Her symptoms resolved six hours after administration of antihistamines and Xopenex, but did not require epinephrine. This would support her childhood reaction to marshmallows. Together these findings make a compelling argument that gelatin, not mammalian meat, was the true allergen responsible for her FDEIA."

Dermatology • Immunology • Pruritus • Pulmonary Disease • Urticaria

WHAT A TUNA SANDWICH CAN DO: A FISHY CASE OF CARDIOGENIC SHOCK (CHEST 2025) - "The pain worsened with breathing and did not respond to nitroglycerin. He received diphenhydramine, partially relieving pruritus...Vasopressors and dobutamine were tapered, and a steroid taper was initiated... The pathophysiology of the case described is allergic and our patient was primarily managed with levalbuterol famotidine, and montelukast... Our case illustrates the clinical course and cardiac imaging findings in cardiogenic shock mediated by acut histamine release in scombroid poisoning from consumption of unrefrigerated fish. We captured an interesting video of diffus myocardial ischemia with basal hypokinesis on the echocardiogram. There are no clear guidelines about whether epinephrine indicated for treating or preventing allergic coronary vasospasm."

Clinical • Cardiomyopathy • Cardiovascular • Dermatology • Eosinophilia • Hypotension • Immunology • Inflammation • Myocardial Ischemia • Pruritus • Respiratory Diseases • Urticaria • Ventricular Tachycardia

Relationship between highly effective modulator therapy, airway clearance compliance, and FEV1% in cystic fibrosis patients (NACFC 2025) - "Adult Patients who started elexacaftor/tezacaftor/ivacaftor (ETI) therapy between the years 2019– 2022 were included. Both the groups that continued AC and discontinued AC had significant increases in lung function as measured by FEV1% after starting ETI therapy. The discontinuation group had an increase (%) in ppFEV1% of 14% vs 10% in the continuation of AC group. This suggests there may be little benefit to routine lengthy AC therapy regimens in stable pwCF on ETI therapy, although it may also be the case that patients who were more stable and had fewer symptoms chose to discontinue therapy, whereas those with more residual disease continued therapy and gained more benefit."

Clinical • Compliance • Cystic Fibrosis • Genetic Disorders • Immunology • Respiratory Diseases

Unraveling the Ties Between Betel Nut Chewing, Obstructive Airway Disease, Zenker Diverticulum, and Gastro-esophageal Reflux Disease (ATS 2025) - "Discussion Arecoline, a cholinergic alkaloid is one of the primary components of betel nut (Areca Catechu) and can cause increase in eotaxin-1 levels and chronic inflammatory changes leading to Asthma and COPD respectively. In patients with recurrent COPD exacerbations, a thorough search for culture-specific practices like betel nut chewing amongst others is warranted and abstinence from such practices can aid in reducing morbidity."

Asthma • Chronic Obstructive Pulmonary Disease • Cough • Esophageal Cancer • Fibrosis • Gastroenterology • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Immunology • Oncology • Pulmonary Disease • Pulmonary Emphysema • Respiratory Diseases • CCL11

Expect the Unexpected: A Classic Presentation of an Uncommon Disorder: A Case of Tracheobronchopathia Osteochondroplastica (ATS 2025) - "Invasive procedures including laser ablation, cryotherapy, external beam radiotherapy, or nodule excision are needed to correct significant airway obstruction or stenosis. Increased awareness of TPO is needed to enhance clinical suspicion and aid in the diagnosis of this rare disease."

Clinical • Allergic Rhinitis • Asthma • Cough • Fibromyalgia • Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease • Mood Disorders • Musculoskeletal Pain • Pain • Psychiatry • Pulmonary Disease • Rare Diseases • Respiratory Diseases • Rheumatology • Ulcerative Colitis

Beta2-Adrenergic Suppression of Neuroinflammation in Treatment of Parkinsonism, with Relevance for Neurodegenerative and Neoplastic Disorders. (PubMed, Biomedicines) - "The present study focuses on the importance of the prototypical β2-adrenergic agonist epinephrine in relation to the incidence of Parkinson's disease in humans, and its further investigation via synthetic selective β2-receptor agonists, such as levalbuterol. Upon toxic activation with mononuclear antibodies, levalbuterol inhibited (1) the release of the eosinophil attractant chemokine eotaxin-1, which is implicated in CNS and peripheral inflammatory disorders, (2) elaboration of the tumor-promoting angiogenic factor VEGFa, and (3) release of the pro-inflammatory cytokine IL-13 from activated PBMCs. These observations suggest possible translation to Parkinson's disease, other neurodegenerative syndromes, and malignancies, via several mechanisms."

Journal • CNS Disorders • Inflammation • Movement Disorders • Oncology • Parkinson's Disease • CCL11 • IL13

Estimating the Economic Impact of Levalbuterol's Potential Transition From the National Reimbursement Drug List for the Treatment of Pediatric Asthma in China: A Budget Impact Analysis. (PubMed, Cureus) - "Sensitivity analysis showed that, for the most part, the results were robust to changes in input parameter values. Conclusions Using levalbuterol may lead to substantial cost savings for Chinese society."

HEOR • Journal • Reimbursement • US reimbursement • Asthma • Immunology • Pediatrics • Pulmonary Disease • Respiratory Diseases

Development and preliminary validation of the personalized cystic fibrosis medication questionnaire (PCF-MQ). (PubMed, J Cyst Fibros) - "The PCF-MQ was correlated with another measure of general CF knowledge, but not health beliefs; because of the small sample size, this should be considered preliminary evidence of its validity. Advantages over existing CF knowledge measures include its practicality for use to help assess pwCF's knowledge about their prescribed regimen."

Journal • Cystic Fibrosis • Genetic Disorders • Immunology • Pulmonary Disease • Respiratory Diseases

Quantifying the Length of Stay and Economic Impact of Albuterol and Levalbuterol in Hospitalized Patients With Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study. (PubMed, Cureus) - "Patients aged 60 or older were more likely to experience longer LOS and higher direct costs. Conclusion This retrospective cohort analysis supports that albuterol was associated with longer LOS and higher costs than levalbuterol."

HEOR • Journal • Retrospective data • Chronic Obstructive Pulmonary Disease • Immunology • Pulmonary Disease • Respiratory Diseases

Coughing Up Chyle: A Rare Case of Pulmonary Lymphangiomatosis With Chyloptysis (ATS 2024) - "He has since been medically managed with furosemide to minimize lymphatic flow into his airways, and airway clearance therapy with cough assist devices and fluticasone-salmeterol and levalbuterol inhalers. Other treatments include diuretics to mobilize lymph from the airways, intravenous immunoglobulin for hypogammaglobulinemia and hypoproteinemia in cases with protein-losing enteropathy, and embolization of lesions. Due to its rarity and variance in presentation, each case report provides insight into how this condition may be successfully managed."

Clinical • Chronic Cough • Cough • Infectious Disease • Inflammation • Pulmonary Disease • Respiratory Diseases

Effectiveness of Medications to Treat Bronchiolitis in the PICU (SCCM 2024) - "We aim to identify associations between the use of bronchodilators, steroids, inhaled 3% saline (HTS), inhaled n-acetylcysteine (NAC) and dornase-alfa (DA) with PICU length of stay (LOS), rate of intubation, and duration of intubation...Steroids included prednisone, prednisolone, methylprednisolone, and dexamethasone... Use of bronchodilators, steroids, HTS, NAC, or DA to treat patients with bronchiolitis in the PICU is not associated with reduced PICU LOS, rate of intubation, or duration of intubation. Additional study with more granular severity of illness scores and timing of therapies is needed to verify our results."

Pediatrics • Pulmonary Disease • Respiratory Diseases

Patterns of Use of Medications to Treat Bronchiolitis in the PICU (SCCM 2024) - "We aim to identify the current use and trends in use of bronchodilators, steroids, inhaled 3% saline (HTS), inhaled n-acetylcysteine (NAC) and dornase-alfa (DA) to treat bronchiolitis in the PICU...Steroids included prednisone, prednisolone, methylprednisolone, and dexamethasone... Bronchodilators, steroids, and HTS are frequently used to treat bronchiolitis. There is large inter-hospital variability in bronchodilator, steroid, and HTS use that can be leveraged to study medication effectiveness."

Pediatrics • Pulmonary Disease • Respiratory Diseases

Levalbuterol Utilization in Hospitalized Patients (AARC 2023) - " Out of 110 patients included in the study and 1,024 levalbuterol nebulizer treatments given (89% had concomitant Ipratropium bromide) only 10% were given with wheezing breath sounds present. This retrospective study quantified the number of levalbuterol doses administered to patients absent of wheezing. The large number of unindicated therapy was seen to be distinctly high in the study location, it can be assumed this is a common finding in many other facilities. There was also, no improvement of oxygen saturation post-delivery of the bronchodilator treatment."

Clinical • Chronic Obstructive Pulmonary Disease

Albuterol Shortage Patient Impact in a Pediatric Emergency Setting (AARC 2023) - "Switching from 0.5 mL albuterol ampules to 90 µg pMDIs had no significant impact on patient admission rates or ICU-level care needed for mild and moderate pediatric patients reporting to the emergency room. LOS was significantly reduced in this patient population with the initiation of pMDIs over nebulized treatments. More research is needed related to cost and time implications of albuterol delivery methods."

Clinical • Asthma • Chronic Obstructive Pulmonary Disease

Pancreatitis Unveiled: A Case Report of IVIG-Induced Acute Pancreatitis (ACG 2023) - "Case Description/ A 70-year-old female with a history of Eosinophilic Asthma on Benralizumab and IVIG, type 2 diabetes, cholecystectomy, and hyperlipidemia presented with right upper quadrant abdominal pain radiating to her back and bloating for 1 day...Medications were notable for Fexofenadine, Insulin, F luticasone Propionate nasal spray , Levalbuterol, and Omeprazole...She previously taken Fenofibrate but stopped 5 months ago...Subsequent workup with EUS is warranted to evaluate further for microlithiasis or other etiology. Figure: Acute intersitial pancreatitis observed on CT abdomen coronal and axial views"

Clinical • Anemia • Asthma • Diabetes • Dyslipidemia • Hematological Disorders • Immunology • Inflammation • Pain • Pancreatitis • Pulmonary Disease • Respiratory Diseases • Type 2 Diabetes Mellitus

IF I MOVE, DOES IT EXPLODE? LUNG BULLAE IN INTERSTITIAL LUNG DISEASE ASSOCIATED WITH ACUTE VIRAL PNEUMONIA (CHEST 2023) - " Management included respiratory therapies Q6H with Levalbuterol and Ipratropium, Nirmatrelvir 300 mg/Ritonavir 100 mg, hydroxychloroquine 200 mg POD, Mycophenolate Mofetil 1g POD, and Prednisone 5 mg POD. More studies should be done regarding possible complications and rehabilitations regarding large bullae of certain proportions for this patient population."

Cardiovascular • Cough • Dyslipidemia • Endocrine Disorders • Hematological Disorders • Infectious Disease • Inflammatory Arthritis • Influenza • Interstitial Lung Disease • Metabolic Disorders • Novel Coronavirus Disease • Pain • Pneumonia • Pulmonary Disease • Respiratory Diseases • Rheumatology

Apical Ballooning Syndrome in the Setting of Severe Chronic Obstructive Pulmonary Disease Exacerbation (AHA 2022) - "The patient was diagnosed with severe COPD exacerbation and received multiple doses of albuterol, methylprednisolone, ipratropium bromide/albuterol, and azithromycin...After intubation, the patient received a continuous albuterol nebulizer, methylprednisolone, and ceftriaxone...This case may raise awareness that the extensive use of albuterol could have dramatic effects. Early switch to beta-2 agonist with higher specificity such as levalbuterol could be a reasonable approach in patients with severe COPD exacerbation."

Asthma • Cardiomyopathy • Cardiovascular • Chronic Obstructive Pulmonary Disease • Coronary Artery Disease • Immunology • Movement Disorders • Pain • Pulmonary Disease • Respiratory Diseases

Hospital Level Variation in the Use of Bronchodilators in Patients With ARDS (ATS 2023) - "The use of routine bronchodilators in ARDS varied widely based upon hospital admission. Though we found no association between a hospital’s albuterol use and mortality, no prior studies have shown benefit, and many have shown increased harm. Thus, hospitals should consider de-implementation of routine use of albuterol in ARDS."

Clinical • Acute Respiratory Distress Syndrome • Asthma • Bronchiectasis • Chronic Obstructive Pulmonary Disease • Immunology • Pulmonary Disease • Respiratory Diseases

"Hospital pharmacist here. Amoxicillin, augmentin, albuterol, levalbuterol, tamiflu, etomidate, albumin, anything with lidocaine in it. The list goes on and on. Scary times we are living in" (@Michell99168268)

Clinical

"I literally just got an order for xopenex for the airway leak" (@ineedrtSTAT)