Pirbuterol (Exirel - Pfizer) is a β2-adrenergic agonist marketed last year for the treatment of bronchial asthma, chronic bronchitis, and emphysema. Advertisements say ‘Exirel may go beyond the immediate relief of bronchospasm’, and that its beneficial effects on pulmonary circulation and the right heart ‘may ultimately help to break the destructive progression’ of these diseases to cor pulmonale and heart failure. The manufacturer also claims superiority over salbutamol because of its longer duration of action and its greater selectivity for lung tissue. The promotional tactics have been criticised in the Lancet.1
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