Xopenex is not new and has been around for several years.
How much research have you done on both Xopenex and Albuterol to understand the chemical difference?
Does the single isomer difference for the inflammatory stimuli make that much difference?
Who is talking up Xopenex to you?
Have you thoroughly read through the healthcare professional information for both of these medications on their websites?
Can you list the advantages and disadvantage of each?
What type of patient is more likely to respond better to Xopenex and will you be able to know this in the field?
Do you plan on doing a continuous mixture (which should not be just dumping a bunch of single doses into a nebulizer)?
Are you planning on doing back to back Xopenex nebs?
Are you going to carry all 3 dosages?
Personal opinons are great but without some hard data such as FEV1s it may be difficult to back up what the actual etiology of the wheezing or the benefits of the medications.
There feelings are mixed for Xopenex vs Albuterol. If a patient has decompensated enough to call an ambulance, it is unlikely that either med will be effective immediately if at all at the regular dose and delivery method. Different types of nebulizers or MDI delivery can definitely affect the patient's response. If the patient has inhalers/nebulizers as home, chances are they have reached their limit. Will Xopenex make a great difference? Maybe or maybe not. The underlying inflammation and/or infection will dictate the course of treatment.