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1
Levine, Hagit, Ophir Bar-On, Vered Nir, Nicole West, Yotam Dizitzer, Huda Mussaffi, and Dario Prais. "Reversible Bronchial Obstruction in Primary Ciliary Dyskinesia." Journal of Clinical Medicine 11, no. 22 (November 16, 2022): 6791. http://dx.doi.org/10.3390/jcm11226791.
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Background: Inhaled bronchodilators are frequently used among patients with primary ciliary dyskinesia (PCD), although neither the effectiveness nor the prevalence of their use is known, due to the paucity of relevant studies. Methods: This is a retrospective analysis of pre- and post-bronchodilator spirometry results, of patients with PCD from two centers. Correlations were examined of bronchodilator response, with asthma and atopy markers. Results: Of 115 patients, 46 (40%) completed spirometry pre- and post-bronchodilation. Of these, 26 (56.5%) demonstrated reversible airway obstruction (increase in %FEV1 predicted ≥ 10%). Obstruction reversibility was not found to be associated with a family history of asthma, blood eosinophil level, elevated IgE, or atopy symptoms. Of the 46 patients who completed bronchodilator spirometry, 29 (63%) were regularly using bronchodilators and inhaled corticosteroids. Conclusions: More than half of patients with PCD presented with reversible airway obstruction, without any correlation to markers of personal or familial atopy. Inhaled bronchodilators and corticosteroid therapies are commonly used for treating PCD. Evaluating bronchodilator response should be considered, and its effectiveness should be further studied.
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Lloberes, P., L. Ramis, JM Montserrat, J. Serra, J. Campistol, C. Picado, and A. Agusti-Vidal. "Effect of three different bronchodilators during an exacerbation of chronic obstructive pulmonary disease." European Respiratory Journal 1, no. 6 (June 1, 1988): 536–39. http://dx.doi.org/10.1183/09031936.93.01060536.
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This study evaluates the effect of three different bronchodilators (beta 2-adrenergic, anticholinergic and methylxanthine) alone and in randomized sequence, during an exacerbation in thirteen patients with chronic obstructive pulmonary disease. Dose-response curves were obtained for inhaled salbutamol and inhaled ipratropium bromide. The bronchodilator effect of a perfusion of aminophylline was also assessed. When a plateau of bronchodilatation was achieved with one agent, one dose of a second bronchodilator was administered to see whether additional bronchodilation could be achieved. The increments in FEV1 and FVC were similar with the three agents. The addition of a second bronchodilator did not result in significant increments in most of the patients. In at least half of the patients the doses of salbutamol and ipratropium that produced the maximal bronchodilatation were twice that currently employed.
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Cazzola, Mario, Clive Page, and Maria Gabriella Matera. "Ensifentrine: A First-in-class Bifunctional Drug for the Treatment of Chronic Obstructive Pulmonary Disease." US Respiratory & Pulmonary Diseases 7, no. 2 (2022): 48. http://dx.doi.org/10.17925/usrpd.2022.7.2.48.
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Ensifentrine is an inhaled ‘bifunctional’ dual phosphodiesterase 3/4 inhibitor that exhibits both bronchodilator and anti-inflammatory activities. Preclinical research has shown that ensifentrine can induce significant relaxation of human bronchi in vitro and suggested the possibility of a synergistic interaction between ensifentrine and β2-adrenoceptor agonists and, mainly, muscarinic receptor antagonists. Ensifentrine is the only dual phosphodiesterase 3/4 inhibitor under clinical development for the treatment of chronic obstructive pulmonary disease (COPD). It has been shown to induce bronchodilation, with a peak bronchodilator effect in patients with COPD similar to that seen after salbutamol administration, and anti-inflammatory activity in healthy individuals. Combined with standard bronchodilators (salbutamol, ipratropium or tiotropium), ensifentrine causes additional bronchodilation and, importantly, a significant reduction in hyperinflation in patients with stable moderate to severe COPD. A recent statement on the top-line phase III ENHANCE-2 study reported that ensifentrine induced significant bronchodilation and reduced the risk of moderate-to-severe COPD exacerbations in study participants. Ensifentrine continues to show promise as a novel drug for treating patients with COPD. Nevertheless, it is necessary to understand whether ensifentrine will be able to replace or reduce the use of currently available classes of bronchodilators, and/or whether it will be a valuable add-on therapy to the current standard of care to further optimize bronchodilation. Furthermore, it will be critical to clarify the anti-inflammatory profile of ensifentrine.
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Kopel, Lianne S., Elizabeth S. Klings, Michael C. Monuteaux, Jonathan M. Gaffin, Matthew M. Heeney, and Wanda Phipatanakul. "Bronchodilator Use for Acute Chest Syndrome Among Large Pediatric Hospitals in North America." Clinical Pediatrics 57, no. 14 (September 3, 2018): 1630–37. http://dx.doi.org/10.1177/0009922818796661.
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The utility of bronchodilators to treat acute chest syndrome (ACS) in patients with sickle cell disease is unknown. Our objectives were to examine the variability in bronchodilator use for ACS among pediatric hospitals contributing to a large database and to examine the relationship between bronchodilator use and length of stay (LOS) and mortality. Between 2005 and 2011, bronchodilators were used during 6812/11 328 hospitalizations (60.1%) and use varied from 0.0% to 97.0% (median = 46.0%, interquartile range = 37.0% to 74.0%). Median LOS was 4 days, and interquartile range was 2 to 6 days. Bronchodilator use was associated with a 13.2% increase in LOS (95% confidence interval = 9.2% to 17.3%, P < .001). However, in the subgroup with asthma, bronchodilator use was associated with a 17.9% decrease in LOS (95% confidence interval = 1.7% to 31.4%, P = .03). There is wide variability in bronchodilator use for ACS, and it has variable association with LOS, depending on comorbid asthma. Prospective trials are needed to evaluate bronchodilators for ACS.
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Clifford, Rachel L., and Alan J. Knox. "Future bronchodilator therapy: a bitter pill to swallow?" American Journal of Physiology-Lung Cellular and Molecular Physiology 303, no. 11 (December 1, 2012): L953—L955. http://dx.doi.org/10.1152/ajplung.00303.2012.
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Maintenance of airway tone, prevention of airway obstruction, and acute relief from bronchospasm are key targets of asthma therapy. This role is currently performed by β-agonists. However, chronic use of β-agonists to treat asthma is associated with desensitization of β-agonist signaling and a resultant loss of bronchodilator effect, worsening of airway hyperreactivity, and increased incidence of asthma-related morbidity and mortality. There have been several attempts to identify novel non-β-agonist bronchodilators including ATP-sensitive potassium channel (KATP) agonists such as cromakalim and its active enantiomer BRL-38227 and the cGMP activators atrial natriuretic peptide (ANP) and BAY 41-22722. However, these either have not made it to clinical trial, required high doses, had little effect in patients, or had a high incidence of side effects. Recent data suggests that a novel bronchodilator target exists, the bitter taste receptor TAS2R. Two recent studies [An SS, Wang WC, Koziol-White CJ, Ahn K, Lee DY, Kurten RC, Panettieri RA Jr, Liggett SB. Am J Physiol Lung Cell Mol Physiol 303: L304–L311, 2012; Pulkkinen V, Manson ML, Säfholm J, Adner M, Dahlén SE. Am J Physiol Lung Cell Mol Physiol. doi:10.1152/ajplung.00205.2012.] provide new understanding of the signaling pathways utilized by TAS2Rs to mediate their bronchodilatory effects and how TAS2R-mediated bronchodilation is affected by β-agonist signaling desensitization. As our understanding of TAS2Rs and their agonists increases, they move closer to a viable therapeutic option; however, further definition is still required and questions remain to be answered. This editorial focus discusses these studies within the context of existing literature and raises questions and challenges for the future development of bitter (better?) therapies for asthma.
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Rechkina, Olena, Vira Stryzh, and Serhii Rudenko. "LEVEL ASSESSMENT OF CONTROL OF BRONCHIAL ASTHMA IN ADOLESCENTS." JOURNAL OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE, no. 3 2021 (October 29, 2021): 192–98. http://dx.doi.org/10.37621/jnamsu-2021-3-5.
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Introduction. The problem of controlling bronchial asthma in adolescents remains relevant, and its monitoring is more difficult than in other age categories, since during the period of long-term remission the disease can be accompanied by signs of bronchial hyperreactivity to nonspecific irritants, and pulmonary ventilation disorders can have a «latent» character, persisting much longer than the clinical symptoms of the disease, which leads to tactical errors in determining the level of bronchial asthma control and is a risk factor for its progression. Aim: to develop a method for assessing the level of bronchial asthma control in adolescents, when there are no clinical, anamnestic and functional signs of insufficient control of asthma, by using a quality of life questionnaire and an additional bronchodilatory test. Materials and methods. The study included 43 adolescents with mild (41.9 %) and moderate (58.1 %) controlled bronchial asthma. To identify cases of «latent» bronchospasm, a bronchodilatory test with salbutamol was performed and the increase in forced expiratory volume in 1 second (FEV1) was calculated. In the case of an increase in FEV1 ≥ 12.0 %, the presence of «latent» bronchospasm was confirmed. If the increase in FEV1 turned out to be < 12.0 %, a questionnaire was performed using the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) and if the value of the integral indicator of the overall quality of life PAQLQ ≤ 6.5 points, an additional bronchodilator test with a combined bronchodilator (fenoterol / ipratropium bromide). Results. The absence of changes in the initial levels of spirometric parameters was found in all 43 patients (FEV1 > 80.0 %). When carrying out a bronchodilatory test with salbatamol, 7 patients (16.3 %) with a positive response (increase in FEV1 ≥ 12.0 %) were identified, which indicated cases of «latent» bronchospasm and partial control of asthma, and 36 people (83.7 %) with a negative answer (increase in FEV1 < 12.0 %). Among 36 patients with an increase in FEV1 < 12.0 % in the test with salbutamol applied the PAQLQ questionnaire and identified 24 people or 66.7 % with an overall quality of life of ≤ 6.5 points, which reflected the negative impact of adolescents asthma on the quality of life and lack of complete asthma control. This was confirmed in 7 out of 24 people (29.2 %) in an additional bronchodilatory test with a combined bronchodilator, in which they gave a positive response (increase in FEV1 ≥ 12.0 %; r = -0.4, p = 0.02). The reasons for the decrease in the overall quality of life of ≤ 6.5 points in the remaining 17 adolescents were due to psychoemotional states or vegetative-vascular dysfunction, and not to the latent course of «latent» bronchospasm. As a result, among 43 adolescents, 14 patients or 32.6 % with «latent» bronchospasm were found. At the same time, the relative risk of a positive patient response to a bronchodilator test with a combined bronchodilator was 2.1 times higher than during a bronchodilator test with salbutamol (OR = 2.1, 95 % CI 1.1–7.0). Conclusions. Conducting bronchodilatory tests with bronchodilators of various pharmacological groups and questioning patients using the PAQLQ questionnaire on the quality of life makes it possible to establish cases of «latent» bronchospasm even with a negative response to salbutamol, when there are no clinical and anamnestic signs of insufficient asthma control and the FEV1 index exceeds 80.0 % of proper values. Keywords: adolescents, bronchial asthma, control, bronchospasm.
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Adesanoye, Damilola T., and Cynthia J. Willey. "Does Cardiovascular Comorbidity Influence the Prescribing of Bronchodilators in Chronic Obstructive Pulmonary Disease?" Annals of Pharmacotherapy 51, no. 10 (June 2, 2017): 855–61. http://dx.doi.org/10.1177/1060028017712531.
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Background: Cardiovascular disease (CVD) is the most prevalent comorbidity for chronic obstructive pulmonary disease (COPD). Potential adverse cardiovascular events of bronchodilators warrant their cautionary use in the comorbid COPD-CVD population, yet little is known about the prescribing of bronchodilators in this high-risk patient group. Objective: To determine whether comorbid CVD is associated with reduced bronchodilator prescribing in patients with COPD. In addition, we explored how the association was modified by gender, concurrent asthma, and concomitant β-blocker (BB) use. Methods: A cross-sectional study was conducted using the 2010 National Ambulatory Medical Care Survey. All visits among diagnosed COPD patients 40 years and older were examined. Logistic regression on survey-weighted data was used to predict treatment with bronchodilators and determine the influence of gender, asthma, and BBs on bronchodilator prescribing. Results: Among 11 627 061 ambulatory COPD visits, we found a significantly lower bronchodilator treatment rate among patients with comorbid CVD (32.3%) than among patients without CVD (57.6%). The observed effect was modified by gender, asthma, and BBs. Deprescribing was more pronounced for females than males, for nonusers of BBs than users of BBs, and for asthma patients than nonasthma patients. CVD did not affect bronchodilator prescribing in either asthmatic or nonasthmatic males taking BBs. Conclusions: Most COPD patients with concurrent CVD were less likely to be prescribed bronchodilators, with the exception of males who were also prescribed BBs. Thus, this study highlights a specific patient subgroup for whom the guidelines are less likely to be observed.
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Murtisiwi, Lusia. "EVALUATION OF TREATMENT BRONCHODILATORS AND CORTICOSTEROIDS IN COPD INPATIENT IN HOSPITALS DR. MOEWARDI SURAKARTA JANUARY 2016-JUNE 2017." Jurnal Farmasi (Journal of Pharmacy) 1, no. 1 (October 20, 2018): 73–80. http://dx.doi.org/10.37013/jf.v1i1.67.
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Chronic Obstructive Pulmonary Disease (COPD) is one of the cause of mortality and morbidity in worldwide. This study aims to determine the pattern of treatment of bronchodilators with or without corticosteroids and their effects on changes carbon dioxide pressure in blood (PCO2) and oxygen pressure in blood (PO2) in COPD patients of inpatient in RSUD Dr. Moewardi Surakarta January 2016-June 2017. This research is a retrospective descriptive research design, data collecting by tracking medical records patients with 195 samples. The results showed that treatment of COPD patient using single bronchodilator of 30,8%, bronchodilator combination of 57,1%, bronchodilator combination with corticosteroid of 1% and corticosteroid equal to 91,3%.Effect of bronchodilator treatment without corticosteroids on changes in the largest largest PCO2 change of 14.8%, the smallest change in PCO25.9%, the largest PO2 change was 19%, the smallest PO2 change was 5.6%, whereas in patients who received bronchodilator treatment with corticosteroids there was the largest PCO2 change of 87.4%, the smallest PCO2 cha
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Singh, Dave, James F. Donohue, Isabelle H. Boucot, Neil C. Barnes, Chris Compton, and Fernando J. Martinez. "Future concepts in bronchodilation for COPD: dual- versus monotherapy." European Respiratory Review 30, no. 160 (June 1, 2021): 210023. http://dx.doi.org/10.1183/16000617.0023-2021.
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Most patients with COPD are recommended to initiate maintenance therapy with a single long-acting bronchodilator, such as a long-acting muscarinic antagonist or long-acting β2-agonist. However, many patients receiving mono-bronchodilation continue to experience high symptom burden, suggesting that patients are frequently not receiving optimal treatment. Treatment goals for COPD are often broad and not individually tailored, making initial treatment response assessments difficult. A personalised approach to initial maintenance therapy, based upon an individual's symptom burden and exacerbation risk, may be more appropriate.An alternative approach would be to maximise bronchodilation early in the disease course of all patients with COPD. Evidence suggests that dual bronchodilation has greater and consistent efficacy for lung function and symptoms than mono-bronchodilation, whilst potentially reducing the risk of exacerbations and disease deterioration, with a similar safety profile to mono-bronchodilators. Improvements in lung function and symptoms between dual- and mono-bronchodilation have also been demonstrated in maintenance-naïve patients, who are most likely to resemble those at first presentation in a clinical setting. Despite promising results, there are several evidence gaps that need to be addressed to allow decision makers to evaluate the merits of a widespread earlier introduction of dual bronchodilation.
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Kamada, Alan. "PHARMACODYNAMIC EFFECTS OF INHALED DRY POWDER FORMULATIONS OF FENOTEROL AND COLFORSIN IN ASTHMA." Pediatrics 94, no. 2 (August 1, 1994): 264–65. http://dx.doi.org/10.1542/peds.94.2.264a.
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Fenoterol administered by inhalation of dry powder caused less tremor and hypokalemia than the MDI formulation, with similar bronchodilator response. Measurable bronchodilation was also observed with colforsin.
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Sharova, Natalia V., D. V. Cherkashin, C. L. Grishaev, G. G. Kutelev, and A. V. Chumakov. "The values of the modified bronchodilation test glycopyrronium to identify the reversibility of bronchial obstruction in patients with chronic obstructive pulmonary disease." Clinical Medicine (Russian Journal) 96, no. 2 (April 27, 2018): 158–63. http://dx.doi.org/10.18821/0023-2149-2018-96-2-158-163.
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Proposed modification of a bronchodilation test with sequential use of rapidly acting bronchodilators: anticholinergic actions glycopyrronium bromide 50 μg and β2-agonist - salbutamol 400 mcg in patients with stable COPD. Modified bronchodilatation test (MBT), was performed in 48 patients with stable COPD, revealed signs of reversible bronchial obstruction more often than the standard BDT (in 76% of cases, against 25% in primary and 36% in the control groups, respectively). The magnitude of the bronchodilator effect glycopyrrolate, defined on spirometry, comparable to that in sbdt in patients with COPD. The degree of increase in FEV1, FVC, POS patients after MDT was significantly higher than that in the standard theatre (sbdt), which confirms the synergistic effect of double bronchodilatation. Holding mbdt is recommended for detection of reversibility of bronchial obstruction in patients with COPD.
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Singh, Dave, Katharine Abbott-Banner, Thomas Bengtsson, and Kenneth Newman. "The short-term bronchodilator effects of the dual phosphodiesterase 3 and 4 inhibitor RPL554 in COPD." European Respiratory Journal 52, no. 5 (August 30, 2018): 1801074. http://dx.doi.org/10.1183/13993003.01074-2018.
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We investigated the short-term bronchodilator effects of RPL554 (an inhaled dual phosphodiesterase 3 and 4 inhibitor) combined with other bronchodilators in chronic obstructive pulmonary disease patients with reversibility (>150 mL to short-acting bronchodilators).Study 1 was a six-way, placebo-controlled crossover study (n=36) with single doses of RPL554 (6 mg), salbutamol (200 µg), ipratropium (40 µg), RPL554 (6 mg)+salbutamol (200 µg), RPL554 (6 mg)+ipratropium (40 µg) or placebo. Study 2 was a three-way crossover study (n=30) of tiotropium (18 µg) combined with RPL554 (1.5 or 6 mg) or placebo for 3 days. Forced expiratory volume in 1 s (FEV1), lung volumes and specific airway conductance (sGaw) were measured.In study 1, peak FEV1 change compared with placebo was similar with RPL554, ipratropium and salbutamol (mean 223, 199 and 187 mL, respectively). The peak FEV1 was higher for RPL554+ipratropium versus ipratropium (mean difference 94 mL; p<0.0001) and RPL554+salbutamol versus salbutamol (mean difference 108 mL; p<0.0001). In study 2 (day 3), both RPL554 doses caused greater peak FEV1 effects than placebo. The average FEV1(0–12 h) increase was greater with RPL554 6 mg only versus placebo (mean difference 65 mL; p=0.0009). In both studies, lung volumes and sGaw showed greater RPL554 combination treatment effects versus monotherapy.RPL554 combined with standard bronchodilators caused additional bronchodilation and hyperinflation reduction.
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Donovan, Chantal, Huei Jiunn Seow, Jane E. Bourke, and Ross Vlahos. "Influenza A virus infection and cigarette smoke impair bronchodilator responsiveness to β-adrenoceptor agonists in mouse lung." Clinical Science 130, no. 10 (April 10, 2016): 829–37. http://dx.doi.org/10.1042/cs20160093.
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The present study has shown that the bronchodilator effectiveness of β-adrenoceptor agonists is diminished in CS and influenza A virus-induced lung disease and has identified the need for the development of novel bronchodilators for these diseases.
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Cazzola, Mario, Paola Rogliani, and Maria Gabriella Matera. "The future of bronchodilation: looking for new classes of bronchodilators." European Respiratory Review 28, no. 154 (December 23, 2019): 190095. http://dx.doi.org/10.1183/16000617.0095-2019.
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Available bronchodilators can satisfy many of the needs of patients suffering from airway disorders, but they often do not relieve symptoms and their long-term use raises safety concerns. Therefore, there is interest in developing new classes that could help to overcome the limits that characterise the existing classes.At least nine potential new classes of bronchodilators have been identified: 1) selective phosphodiesterase inhibitors; 2) bitter-taste receptor agonists; 3) E-prostanoid receptor 4 agonists; 4) Rho kinase inhibitors; 5) calcilytics; 6) agonists of peroxisome proliferator-activated receptor-γ; 7) agonists of relaxin receptor 1; 8) soluble guanylyl cyclase activators; and 9) pepducins. They are under consideration, but they are mostly in a preclinical phase and, consequently, we still do not know which classes will actually be developed for clinical use and whether it will be proven that a possible clinical benefit outweighs the impact of any adverse effect.It is likely that if developed, these new classes may be a useful addition to, rather than a substitution of, the bronchodilator therapy currently used, in order to achieve further optimisation of bronchodilation.
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Thompson, D. C., J. L. Szarek, R. J. Altiere, and L. Diamond. "Nonadrenergic bronchodilation induced by high concentrations of sulfur dioxide." Journal of Applied Physiology 69, no. 5 (November 1, 1990): 1786–91. http://dx.doi.org/10.1152/jappl.1990.69.5.1786.
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SO2 is an environmental pollutant known to elicit bronchospasm in susceptible subjects. We observed that brief exposure of artificially bronchoconstricted cats to high concentrations of SO2 induces a bronchodilator response. This study assessed the characteristics of this response and examined various mechanisms that might underlie it. Cats were anesthetized with diallylbarbital-urethan, and airway smooth muscle tone, measured by lung resistance and dynamic lung compliance, was elevated with a continuous infusion of 5-hydroxytryptamine. Administration of 10 breaths of SO2 via a tracheostomy induced concentration-dependent bronchodilation in the range 100-1,000 parts/million. Only infrequently was bronchoconstriction observed before bronchodilation. SO2-induced bronchodilator responses were unaffected by pretreatment with intravenous atropine or propranolol, establishing them as nonadrenergic noncholinergic (NANC) in origin. Neither the ganglionic blocking agent hexamethonium nor the nerve toxin tetrodotoxin influenced the SO2-induced bronchodilation, thus excluding a role for central or local autonomic reflexes in the response. Efforts to modulate the response by pretreatment with the cyclooxygenase inhibitor indomethacin or the mediator release inhibitor cromolyn sodium also were unsuccessful. Administration of acidic aerosols failed to mimic the SO2-induced bronchodilator response. Although the mechanism whereby SO2 induces bronchodilation under these experimental conditions remains unclear, release of a NANC inhibitory transmitter from a neural, epithelial, or other cellular source via a mechanism insensitive to both tetrodotoxin and cromolyn is a distinct possibility. An intrinsic NANC inhibitory system may exist in feline airways functioning as a local regulator of bronchomotor tone and possibly serving to override responses to strong, potentially asphyxial bronchoconstrictive stimuli.
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Sharova, Natalia V., Dmitriy V. Cherkashin, Sergey L. Grishayev, Semen V. Efimov, Mikhail A. Kharitonov, and Sayera A. Turdialieva. "Features and significance of the early bronchodilatation effect of the first dose of a long-acting bronchodilator alone and in fixed combination in the treatment of chronic obstructive pulmonary disease." Bulletin of the Russian Military Medical Academy 24, no. 1 (April 20, 2022): 25–34. http://dx.doi.org/10.17816/brmma88616.
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The early bronchodilatory effects of the first dose of long-acting anticholinergics (glycopyrronium and tiotropium) were compared with those of a fixed double combination of long-acting bronchodilators of various classes (indacaterol/glycopyrronium) in patients with stable chronic obstructive pulmonary disease. The possibility of using the results of an early bronchodilatory response to predict their effectiveness in the basic therapy of chronic obstructive pulmonary disease is evaluated. A total of 176 patients with chronic obstructive pulmonary disease were examined. The patients were randomized into three groups. The first group (n = 66) took glycopyrronium, the second group (n = 60) received a combination of indacaterol/glycopyrronium, and the third group (n = 50, control) took tiotropium. Broncholytic tests with the listed drugs were evaluated. The early bronchodilatory effect of the first dose of 110/50 mcg indacaterol/glycopyrronium was manifested by significant bronchodilation (p 0.001) from 30 min, reached its maximum value 60 min after drug intake, and persisted after a 28-day course of treatment. The combination of indacaterol/glycopyrronium provided rapid and prolonged bronchodilation in patients with stable chronic obstructive pulmonary disease, demonstrating advantages over the isolated use of glycopyrronium and tiotropium. Maximization of bronchodilation by the sequential use of glycopyrronium and salbutamol leads to an increase in the volume of forced exhalation in the first second on the 90th min, comparable with the results of indacaterol/glycopyrronium on the 60th min after drug intake, which indicates the clinical feasibility of maximizing bronchodilation with drugs both separately and in combination. Based on a direct positive correlation between the initial value of the forced expiratory volume in the first second and the value on day 28 of indacaterol/glycopyrronium therapy, an equation for predicting the individual effectiveness of the drug during treatment is derived.
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Kodaka, Norio, Toru Yamagishi, Kayo Watanabe, Kumiko Kishimoto, Chihiro Nakano, Takeshi Oshio, Kumiko Niitsuma, Nagashige Shimada, and Hiroto Matsuse. "Evaluation of Inhaled Procaterol for Potential Assist Use in Patients with Stable Chronic Obstructive Pulmonary Disease." Medical Principles and Practice 27, no. 4 (2018): 350–55. http://dx.doi.org/10.1159/000490146.
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Objectives: International guidelines recommend the use of long-acting bronchodilators for the treatment of chronic obstructive pulmonary disease (COPD), but the usefulness of short-acting bronchodilator assist use for stable COPD remains uncertain. The purpose of the present study was to objectively demonstrate the effects of assist use of procaterol, a short-acting β2-agonist, on the respiratory mechanics of stable COPD patients treated with a long-acting bronchodilator using forced oscillation technique (FOT) and conventional spirometry. We also confirmed the length of time for which procaterol assist could significantly improve the pulmonary function. Methods: We enrolled 28 outpatients with mild to severe COPD (Global Initiative for Obstructive Lung Disease stages I–III), who had used the same long-acting bronchodilator for longer than 3 months and who were in stable condition. All measures were performed using both FOT and spirometry sequentially from 15 min to 2 h after inhalation. Results: Compared to baseline, inhaled procaterol assist use modestly but significantly improved spirometric and FOT measurements within 2 h after inhalation. These significant effects continued for at least 2 h. Significant correlations were found between parameters measured by spirometry and those measured by FOT. Conclusions: Procaterol assist use modestly but significantly improved pulmonary function determined by spirometry and respiratory mechanics in patients with stable COPD treated with long-acting bronchodilators. Thus, inhaled procaterol has the potential for assist use for COPD.
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Keddissi, Jean I., Marwan K. Elya, Saif U. Farooq, Houssein A. Youness, Kellie R. Jones, Ahmed Awab, and Gary T. Kinasewitz. "Bronchial Responsiveness in Patients with Restrictive Spirometry." BioMed Research International 2013 (2013): 1–5. http://dx.doi.org/10.1155/2013/498205.
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Background. Improvement in PFT after bronchodilators is characteristic of obstructive airway diseases such as COPD. However, improvement in patients with restrictive pattern is occasionally seen. We aim to determine the clinical significance of a bronchodilator responsive restrictive defect.Methods. Patients with restrictive spirometry and a bronchodilator study were identified at the University of Oklahoma and Oklahoma City VAMC between September 2003 and December 2009. Restriction was defined as a decreased FVC and FEV1, with normal FEV1/FVC. Responsiveness to bronchodilators was defined as an improvement in FEV1 and/or FVC of at least 12% and 200 mL. Patients with lung volume measurements had their clinical and radiographic records reviewed.Results. Twenty-one patients were included in the study. Most were current or ex-smokers, with most being on bronchodilators. The average FVC and FEV1 were65±11%and62±10%of the predicted, respectively. Most patients (66%) had a normal TLC, averaging90±16%of the predicted. RV, RV/TLC, and the TLC-VA values strongly suggested an obstructive defect.Conclusions. Reversible restrictive pattern on spirometry appears to be a variant of obstructive lung disease in which early airway closure results in air trapping and low FVC. In symptomatic patients, a therapeutic trial of bronchodilators may be beneficial.
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Lammers, J. W., P. Minette, M. T. McCusker, K. F. Chung, and P. J. Barnes. "Nonadrenergic bronchodilator mechanisms in normal human subjects in vivo." Journal of Applied Physiology 64, no. 5 (May 1, 1988): 1817–22. http://dx.doi.org/10.1152/jappl.1988.64.5.1817.
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In seven normal subjects we investigated whether a nonadrenergic bronchodilator nervous system is demonstrable in humans in vivo. After inhalation of leukotriene D4 (LTD4), respiratory resistance (Rrs) increased by 115 +/- 11% (SE). Subsequent inhalation of 2 nmol of capsaicin induced coughing and a fall in Rrs of 22.1 +/- 2% (P less than 0.01). However, inhalation of the diluent of capsaicin, 10% saline-ethanol, decreased Rrs similarly. These bronchodilator responses were not altered by inhaled ipratropium bromide (120 micrograms) and oral propranolol (80 mg). After ipratropium and propranolol, voluntary coughing alone decreased Rrs by 25 +/- 3% (P less than 0.05). We next investigated whether these bronchodilator responses could be blocked by anesthesia of the airways with inhaled lidocaine. After inhalation of lidocaine and LTD4, capsaicin aerosol induced coughing and a transient increase in Rrs of 18 +/- 6% (P less than 0.05) but no bronchodilation. Inhalation of saline-ethanol (n = 4) and a deep inhalation (n = 6) decreased Rrs by 18 +/- 4% (P less than 0.05) and 34 +/- 3% (P less than 0.001), respectively. We conclude that in normal subjects a nonadrenergic, noncholinergic bronchodilator mechanism exists, which can be activated by inhalation of capsaicin and inhibited by local anesthesia.
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Boutin, Bernard, Marc Koskas, Houda Guillo, Lucia Maingot, Marie-Claude La Rocca, Michèle Boulé, Jocelyne Just, Isabelle Momas, Alberti Corinne, and Nicole Beydon. "Forced expiratory flows’ contribution to lung function interpretation in schoolchildren." European Respiratory Journal 45, no. 1 (September 3, 2014): 107–15. http://dx.doi.org/10.1183/09031936.00062814.
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Forced expiratory flow (FEF) at low lung volumes are supposed to be better at detecting lung-function impairment in asthmatic children than a forced volume. The aim of this study was to examine whether FEF results could modify the interpretation of baseline and post-bronchodilator spirometry in asthmatic schoolchildren in whom forced expiratory volumes are within the normal range.Spirometry, with post-bronchodilator vital capacity within 10% of that of baseline in healthy and asthmatic children, was recorded prospectively. We defined abnormal baseline values expressed as z-scores <-1.645, forced expiratory volume in 1 s (FEV1) reversibility as a baseline increase >12%, FEF reversibility as an increase larger than the 2.5th percentile of post-bronchodilator changes in healthy children.Among 66 healthy and 50 asthmatic schoolchildren, only two (1.7%) children with normal vital capacity and no airways obstruction had abnormal baseline forced expiratory flow at 25–75% of forced vital capacity (FEF25–75%). After bronchodilation, among the 45 asthmatic children without FEV1 reversibility, 5 (11.1%) had an FEF25–75% increase that exceeded the reference interval.Isolated abnormal baseline values or significant post-bronchodilator changes in FEF are rare situations in asthmatic schoolchildren with good spirometry quality.
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Craig, Simon, Colin V. E. Powell, Gillian M. Nixon, Ed Oakley, Jason Hort, David S. Armstrong, Sarath Ranganathan, et al. "Treatment patterns and frequency of key outcomes in acute severe asthma in children: a Paediatric Research in Emergency Departments International Collaborative (PREDICT) multicentre cohort study." BMJ Open Respiratory Research 9, no. 1 (March 2022): e001137. http://dx.doi.org/10.1136/bmjresp-2021-001137.
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RationaleSevere acute paediatric asthma may require treatment escalation beyond systemic corticosteroids, inhaled bronchodilators and low-flow oxygen. Current large asthma datasets report parenteral therapy only.ObjectivesTo identify the use and type of escalation of treatment in children presenting to hospital with acute severe asthma.MethodsRetrospective cohort study of children with an emergency department diagnosis of asthma or wheeze at 18 Australian and New Zealand hospitals. The main outcomes were use and type of escalation treatment (defined as any of intensive care unit admission, nebulised magnesium, respiratory support or parenteral bronchodilator treatment) and hospital length of stay (LOS).Measurements and main resultsOf 14 029 children (median age 3 (IQR 1–3) years; 62.9% male), 1020 (7.3%, 95% CI 6.9% to 7.7%) had treatment escalation. Children with treatment escalation had a longer LOS (44.2 hours, IQR 27.3–63.2 hours) than children without escalation 6.7 hours, IQR 3.5–16.3 hours; p<0.001). The most common treatment escalations were respiratory support alone (400; 2.9%, 95% CI 2.6% to 3.1%), parenteral bronchodilator treatment alone (380; 2.7%, 95% CI 2.5% to 3.0%) and both respiratory support and parenteral bronchodilator treatment (209; 1.5%, 95% CI 1.3% to 1.7%). Respiratory support was predominantly nasal high-flow therapy (99.0%). The most common intravenous medication regimens were: magnesium alone (50.4%), magnesium and aminophylline (24.6%) and magnesium and salbutamol (10.0%).ConclusionsOverall, 7.3% children with acute severe asthma received some form of escalated treatment, with 4.2% receiving parenteral bronchodilators and 4.3% respiratory support. There is wide variation treatment escalation.
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Hernández, Laura Carrasco, Candela Caballero Eraso, Borja Ruiz-Duque, María Abad Arranz, Eduardo Márquez Martín, Carmen Calero Acuña, and Jose Luis Lopez-Campos. "Predictors of Single Bronchodilation Treatment Response for COPD: An Observational Study with the Trace Database Cohort." Journal of Clinical Medicine 10, no. 8 (April 15, 2021): 1708. http://dx.doi.org/10.3390/jcm10081708.
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Chronic obstructive pulmonary disease (COPD) patients constitute a heterogeneous population in terms of treatment response. Our objective was to identify possible predictive factors of response to treatment with single bronchodilation monotherapy in patients diagnosed with COPD. The Time-based Register and Analysis of COPD Endpoints (TRACE; clinicaltrials.gov NCT03485690) is a prospective cohort of COPD patients who have been attending annual visits since 2012. Patients who were kept on a single bronchodilator during the first year of follow-up were selected. The responders were defined according to all of the following variables: any improvement in morning post-dose forced expiratory volume in 1 s or deterioration <100 mL, no change or improvement in dyspnea score, and no occurrence of exacerbations. Significant and plausible variables were analyzed using a proportional hazard Cox regression for single bronchodilator responders. We analyzed 764 cases, of whom 128 (16.8%) were receiving monotherapy with one bronchodilator. Of these, 85 patients (66.4%) were responders. Factors affecting responder status were: female gender (hazard ratio (HR) 0.276; 95% confidence interval (CI) 0.089–0.858), dyslipidemia (HR 0.436; 95%CI 0.202–0.939), not performing regular exercise (HR 0.523; 95%CI 0.254–1.076), active smoking (HR 0.413; 95%CI 0.186–0.920), and treatment adherence (HR 2.527; 95%CI 1.271–5.027). The factors associated with a single bronchodilation response are mainly non-pharmacological interventions and comorbidities.
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Li, Jie, Yibing Chen, Stephan Ehrmann, Jie Wu, Lixin Xie, and James B. Fink. "Bronchodilator Delivery via High-Flow Nasal Cannula: A Randomized Controlled Trial to Compare the Effects of Gas Flows." Pharmaceutics 13, no. 10 (October 11, 2021): 1655. http://dx.doi.org/10.3390/pharmaceutics13101655.
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(1) Background: Aerosol delivery via high-flow nasal cannula (HFNC) has attracted increasing clinical interest. In vitro studies report that the ratio of HFNC gas flow to patient inspiratory flow (GF:IF) is a key factor in the efficiency of trans-nasal aerosol delivery. (2) Methods: In a randomized controlled trial, patients with a history of COPD or asthma and documented positive responses to inhaled bronchodilators in an outpatient pulmonary function laboratory were recruited. Subjects were randomized to receive inhalation at gas flow ratio settings of: GF:IF = 0.5, GF:IF = 1.0, or GF = 50 L/min. Subjects were assigned to inhale saline (control) followed by salbutamol via HFNC with cumulative doses of 0.5 mg, 1.5 mg, 3.5 mg, and 7.5 mg. Spirometry was performed at baseline and 10–12 min after each inhalation. (3) Results: 75 subjects (49 asthma and 26 COPD) demonstrating bronchodilator response were enrolled. Per the robust ATS/ERS criteria no difference was observed between flows, however using the criteria of post-bronchodilator forced expiratory volume in the first second (FEV1) reaching the screening post-bronchodilator FEV1 with salbutamol, a higher percentage of subjects receiving GF:IF = 0.5 met the criteria at a cumulative dose of 1.5 mg than those receiving GF:IF = 1.0, and GF = 50 L/min (64% vs. 29% vs. 27%, respectively, p = 0.011). Similarly at 3.5 mg (88% vs. 54% vs. 46%, respectively, p = 0.005). The effective dose at GF:IF = 0.5 was 1.5 mg while for GF = 50 L/min it was 3.5 mg. (4) Conclusions: During salbutamol delivery via HFNC, cumulative doses of 1.5 mg to 3.5 mg resulted in effective bronchodilation. Applying the robust ATS/ERS criteria no difference was observed between the flows, however using the more sensitive criteria of subjects reaching post screening FEV1 to salbutamol via HFNC, a higher number of subjects responded to the doses of 0.5 mg and 1.5 mg when HFNC gas flow was set at 50% of patient peak inspiratory flow.
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Veryanti, Putu Rika, and Ainun Wulandari. "EFFECTIVENESS OF BRONCHODILATOR AND CORTICOSTEROID TREATMENT IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)." Journal of Pharmaceutical Science and Application 2, no. 1 (June 18, 2020): 17. http://dx.doi.org/10.24843/jpsa.2020.v02.i01.p03.
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Background: Chronic Obstructive Pulmonary Disease (COPD) is a chronic airway disease which is characterized by progressive airway obstruction. Bronchodilators and corticosteroids are the first choices of therapy in COPD patients. The goal therapy of COPD patients is to prevent respiratory failure, which can impact on death. But nowadays, the mortality rate due to COPD continues to increase. WHO predicts mortality from COPD in the year 2030 will be ranked third in the world. This high mortality can be caused by the ineffectiveness of therapy given. Objective: The aim of this study is to find out the effectiveness of bronchodilator and corticosteroid treatments in COPD patients. Methods: An observational study conducted retrospectively in the 2018 period at Fatmawati Central General Hospital. The effectiveness of therapy was assessed from the patient's clinical condition, blood gas values (PaO2 & PaCO2) and the average length of stay (AvLOS). Results: COPD was mostly suffered by males (83,33%), and the highest age for COPD was in the range of 45 years and above (90%). Bronchodilator that commonly prescribed were albuterol (30.08%), ipratropium bromide (12.2%), fenoterol hydrobromide (10.57%), terbutaline sulfate (8.13%), theophylline (1.63%) and aminophylline (5.69%), while the corticosteroids were budesonide (17.07%), methylprednisolone (9.76%) and dexamethasone (4.88%). Bronchodilator and corticosteroid had improved patient's clinical condition (96.67% patients) and also improved PaO2 & PaCO2 values patients. There was a significant improvement in PaO2 and PaCO2 value in COPD patients (p <0.05). Conclusion: Bronchodilator and corticosteroid in COPD patients had improved patient's clinical condition and PaO2 & PaCO2 values, but the average length of stay exceeds the standard (6-9 days).
Keywords: Bronchodilator, Corticosteroid, COPD, Blood Gas Analysis, Average Length of Stay
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Tuomisto, Leena E., Pinja Ilmarinen, Lauri Lehtimäki, Onni Niemelä, Minna Tommola, and Hannu Kankaanranta. "Clinical value of bronchodilator response for diagnosing asthma in steroid-naïve adults." ERJ Open Research 7, no. 4 (October 2021): 00293–2021. http://dx.doi.org/10.1183/23120541.00293-2021.
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Spirometry and testing for bronchodilator response have been recommended to detect asthma, and a bronchodilator response (BDR) of ≥12% and ≥200 mL has been suggested to confirm asthma. However, the clinical value of bronchodilation tests in newly diagnosed steroid-naïve adult patients with asthma remains unknown.We evaluated the sensitivity of BDR in forced expiratory volume in 1 s (FEV1) as a diagnostic test for asthma in a real-life cohort of participants in the Seinäjoki Adult Asthma Study. In the diagnostic phase, 369 spirometry tests with bronchodilation were performed for 219 steroid-naïve patients. The fulfilment of each test threshold was assessed. According to the algorithm of the National Institute for Health and Care Excellence, we divided the patients into obstructive (FEV1/forced vital capacity (FVC) <0.70) and non-obstructive (FEV1/FVC ≥0.70) groups.Of the overall cohort, 35.6% fulfilled ΔFEV1 ≥12% and ≥200 mL for the initial FEV1, 18.3% fulfilled ΔFEV1 ≥15% and ≥400 mL for the initial FEV1, and 36.1% fulfilled ΔFEV1 ≥9% of predicted FEV1 at least once. One-third (31%) of these steroid-naïve patients was obstructive (pre-bronchodilator FEV1/FVC <0.7). Of the obstructive patients, 55.9%, 26.5% and 48.5%, respectively, met the same thresholds. In multivariate logistic regression analysis, different thresholds recognised different kinds of asthma patients.In steroid-naïve adult patients, the current BDR threshold (ΔFEV1 ≥12% and ≥200 mL) has low diagnostic sensitivity (36%) for asthma. In obstructive patients, sensitivity is somewhat higher (56%) but far from optimal. If the first spirometry test with bronchodilation is not diagnostic but asthma is suspected, spirometry should be repeated, and other lung function tests should be used to confirm the diagnosis.
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Bateman, Eric D., Gary T. Ferguson, Neil Barnes, Nicola Gallagher, Yulia Green, Michelle Henley, and Donald Banerji. "Dual bronchodilation with QVA149versussingle bronchodilator therapy: the SHINE study." European Respiratory Journal 42, no. 6 (May 30, 2013): 1484–94. http://dx.doi.org/10.1183/09031936.00200212.
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Abukwaik, Aya Wail, Rupal Mansukhani, and Mary Barna Bridgeman. "Long-Acting Bronchodilator Use in the Management of Stable COPD." Annals of Pharmacotherapy 52, no. 6 (December 19, 2017): 562–70. http://dx.doi.org/10.1177/1060028017746697.
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Objective: To review the management of chronic obstructive pulmonary disease (COPD), with a focus on updated information regarding the use of long-acting bronchodilators in the prevention of exacerbations and outcomes associated with this disease. Data Sources: A literature search of the MEDLINE databases through November 2017 was conducted. All published articles regarding use of bronchodilator therapy in the management of COPD were evaluated. References of selected articles, data from poster presentations, and abstract publications were additionally reviewed. Study Selection and Data Extraction: Available English-language data from reviews, abstracts, presentations, and clinical trials of the treatment of stable COPD with bronchodilator therapy in humans were reviewed; relevant clinical data were selected and included. Data Synthesis: COPD is a prevalent medical condition worldwide that results in functional impairment, and worsened quality of life and overall health status. Numerous treatment options are available; the rationale for the optimal agents to utilize in a particular patient case is dependent on a multitude of patient-specific factors and severity of disease. In this review, a discussion of the role of long-acting bronchodilators, including long-acting β agonists and long-acting muscarinic antagonists will be explored. Additionally, an update on the roles of novel delivery devices for delivering respiratory medications in this medical condition will be described. Conclusion: Although numerous treatment options are available, management of COPD remains a clinical challenge. Long-acting bronchodilators represent a significant class of medications that have the potential to reduce exacerbations and related hospitalizations and improve overall health outcomes.
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Rahman, Md Mostafizur, Mohammad Samir Azam Sunny, Abdul Quiyum Chowdhury, Sanjoy Kumar Saha, Md Rezwanul Hoque, and Asit Baran Adhikary. "Pre-operative Bronchodilator Treated Patients Preserve Better Pulmonary Function in CABG Cases." Journal of Surgical Sciences 18, no. 2 (November 4, 2019): 51–56. http://dx.doi.org/10.3329/jss.v18i2.43756.
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Background: Bronchodilator {P2selective adrenergic drug-salbutamol) causes bronchodilation and increases the vital capacity, tidal volume and total lung capacity and reduces gas trapping. Use of bronchodilator in patients undergoing Off-pump coronary artery bypass graft (OPCABG) may lead to better preservation of pulmonary function.
Objective: To evaluate the role of bronchodilator on preservation of post-operative pulmonary function in patients who underwent OPCABG.
Methods: This study was conducted on 50 patients randomized into two groups to assess the pulmonary function after off-pump CABG. Among them, 25 patients (group-I) were treated by preoperatively bronchodilator and compared them with other 25 patients (group-II) who were not treated by preoperative bronchodilator. We compared arterial blood gas analysis, duration of total mechanical ventilation, days spent in the surgical ICU and spirometric indices.
Results: Mean±SE value of mechanical ventilation time after operation in group-I was 14.25±0.85 hours and in group-II was 16.88±0.85 hours. Mean±SE value of ICU stay after surgery was 98.64±2.07 hours in group I and 110.56±2.36 hours in group-II. Both results were statistically significant (P=0.042 and P=0.001 respectively). The FVC and FEV1 after admission were not statistically significant (P>0.05). On the day before surgery the values of FVC and FEV1 were increased (more in group-1 who were treated with bronchodilator) and 7th postoperative day the value were decreased (more in group -11 who were not treated with bronchodilator). The results were found statistically significant in between two groups (P<0.05). Significant difference were found in PaO2 and PaCO2 on arterial blood gas analysis at half an hour after extubation and on 1st POD (P<0.05). Mean±SE value of postoperative hospital day in group-1 was 8.88±0.24 days and in group II was 10.14±0.43 days which was found statistically significant (p=0.014). Among post-operative pulmonary complications, in group 1, one (4%) patient was found with pleural effusion and one (4%) patient with atelectasis. but in group-II, one (4%) patient was found with pleural effusion and five (20%) patients were found with atelectasis.
Conclusion: Use of bronchodilator preoperatively in patients who underwent OPCABG with impaired pulmonary function leads to reduced mechanical ventilation time, less ICU stay after surgery, better preservation of pulmonary function, reduced post-operative pulmonary complications and reduced hospital stay.
Journal of Surgical Sciences (2014) Vol. 18 (2) : 51-56
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Levesque, Matthew, Suyin A. Lum Min, Melanie I. Morris, Anna C. Shawyer, and Richard Keijzer. "Asthma Medication Use in Congenital Diaphragmatic Hernia Survivors: A Retrospective Population Level Data Analysis." European Journal of Pediatric Surgery 30, no. 01 (November 10, 2019): 039–44. http://dx.doi.org/10.1055/s-0039-1698767.
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Abstract Introduction The purpose of this study was to determine if congenital diaphragmatic hernia (CDH) survivors had worse long-term respiratory outcomes compared with age-matched controls, as measured by inhaled bronchodilator use, inhaled steroid use, and asthma-related physician visits. Materials and Methods We performed a retrospective case-control study of infants with isolated CDH from 1991 to 2013. The primary outcome measures were inhaled bronchodilator prescriptions, inhaled steroid prescriptions, and asthma-related physician visits between 0 and 5 years of age and between 5 and 10 years of age. Subgroup analysis compared the same outcomes for CDH patients grouped by: birth weight, gestational age, side of defect, defect size, liver herniation, hernia sac, and pulmonary hypertension. Results Fifty-six patients with CDH and 753 age-matched controls met the inclusion criteria for the 0 to 5 years of age analysis. Between 0 and 5 years of age, more CDH survivors were prescribed an inhaled bronchodilator (odds ratio [OR] = 2.47[1.38–4.48], p = 0.001) and inhaled steroid (OR = 2.03[1.07–3.74], p = 0.03), and had an asthma-related physician visit (OR = 1.92[1.00–3.56], p = 0.04). Thirty-eight cases and 491 controls met the inclusion criteria for the 5 to 10 years of age analysis. Between 5 and 10 years of age, CDH survivors were not more likely to be prescribed inhaled bronchodilators, inhaled steroids, or have an asthma-related physician visit. Among the CDH patients, we did not find a clinical characteristic associated with increased inhaled bronchodilator or steroid prescriptions at any age. Conclusion A history of CDH is associated with higher rates of inhaled bronchodilator prescriptions, inhaled steroid prescriptions, and asthma-related physician visits from 0 to 5 years of age compared with age-matched controls. However, this difference resolves by 5 to 10 years of age.
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Arshad, S. Hasan, Claire Hodgekiss, John W. Holloway, Ramesh Kurukulaaratchy, Wilfried Karmaus, Hongmei Zhang, and Graham Roberts. "Association of asthma and smoking with lung function impairment in adolescence and early adulthood: the Isle of Wight Birth Cohort Study." European Respiratory Journal 55, no. 3 (December 12, 2019): 1900477. http://dx.doi.org/10.1183/13993003.00477-2019.
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We investigated associations of asthma and smoking with lung function and airway reversibility from childhood to early adulthood.The population-based Isle of Wight Birth Cohort (n=1456) was assessed at birth, and at 1, 2, 4, 10, 18 and 26 years. Asthma was defined as physician diagnosis plus current wheeze and/or treatment. Spirometry was conducted at 10 (n=981), 18 (n=839) and 26 years (n=547). Individuals were subdivided into nonsmokers without asthma, nonsmokers with asthma, smokers without asthma and smokers with asthma, based on asthma and smoking status at 26 years. Their lung function trajectories from 10 to 26 years were examined using longitudinal models.Nonsmokers with asthma had smaller forced expiratory volume in 1 s (FEV1), FEF25–75% (forced expiratory flow at 25–75% of forced vital capacity (FVC)) and FEV1/FVC ratio compared to nonsmokers without asthma at age 10 and 18 years, with differences reduced after bronchodilator (pre-bronchodilator FEV1 at 26 years 3.75 L versus 4.02 L, p<0.001; post-bronchodilator 4.02 L versus 4.16 L, p=0.08). This lung function deficit did not worsen after 18 years. Smokers without asthma had smaller FEF25–75% and FEV1/FVC ratio (but not FEV1) at 26 years compared to nonsmokers without asthma, with the deficit appearing after 18 years and persisting despite bronchodilator response (for FEV1/FVC ratio at 26 years 0.80 versus 0.81, p=0.002; post-bronchodilator 0.83 versus 0.85, p=0.005). Smokers with asthma had worse lung function compared to other groups.Lung function deficits associated with asthma and smoking occur early in life. They are not fully responsive to bronchodilators, indicating a risk for long-term lung health, which highlights the need to institute preventive measures in adolescence and early adult life before irreversible damage occurs.
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Kurbacheva, O. M., S. A. Polner, and D. S. Smirnov. "BRONCHOLITIC THERAPY IN BRONCHIAL ASTHMA: PROPER CHOICE." Russian Journal of Allergy 11, no. 5 (December 15, 2014): 28–35. http://dx.doi.org/10.36691/rja499.
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In this article the problems of improving the control of bronchial asthma through optimization of bronchodilator therapy are discussed. Cholinergic mechanisms in the pathogenesis of asthma and the possibilities of use of long-acting m-anticholinergic - tiotropium (via liquid inhaler R espimat) - in the treatment of this disease are shown. Pharmacological properties of bronchodilators are discussed to identify the main groups of patients who need tiotropium therapy.
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Johnson, Jan, and Simon R. Johnson. "Cross-sectional study of reversible airway obstruction in LAM: better evidence is needed for bronchodilator and inhaled steroid use." Thorax 74, no. 10 (July 30, 2019): 999–1002. http://dx.doi.org/10.1136/thoraxjnl-2019-213338.
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Lymphangioleiomyomatosis can be associated with reversible airflow obstruction and although no guidelines around reversibility testing or inhaled therapy exist, many patients receive bronchodilators and inhaled corticosteroids. To better identify those who may benefit, we examined bronchodilator reversibility and inhaled therapy in a national cohort of 213 subjects. 20% of those tested had airway reversibility by standard criteria. 55% of patients used 13 different combinations of bronchodilators and inhaled corticosteroids. Increasing inhaler classes were associated with reversibility and more rapid FEV1 decline. Reversibility testing should be performed in all patients and inhaled therapy should be formally studied.
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Chowdhury, Muhammad Abdul Quaium, Nazmul Hosain, Mohammad Fazle Maruf, Md Mostafizur Rahman, Md Aftabuddin, and Asit Baran Adhikary. "Evaluation of Pulmonary Function after Off-pump Coronary Artery Bypass Grafting in Patients Treated with Preoperative Bronchodilator." Cardiovascular Journal 7, no. 2 (February 16, 2015): 123–27. http://dx.doi.org/10.3329/cardio.v7i2.22260.
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Background: Bronchodilators, by dilatation of bronchial tree through relaxation of bronchial smooth muscle increases the vital capacity, tidal volume and total lung capacity and reduces gas trapping. This study was conducted to assess the pulmonary function after off-pump coronary artery bypass graft (CABG) surgery between patients with impaired pulmonary function treated with or without preoperative bronchodilator. We also compared duration of mechanical ventilation and days spent in the surgical intensive care unit (ICU) after CABG in both group of patients. Methods: This prospective cohort study was carried out in the department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from July 2009 to April 2011. This study included 50 patients (25 patients in each group) with multi-vessels coronary artery disease with impaired pulmonary function who underwent off-pump CABG. Results: Spirometry was done in both groups of patients after admission, day before operation and on 7th post-operative day. The difference in Forced vital capacity (FVC) and Forced expiratory volume in 1st second (FEV1 ) between two groups were not statistically significant after admission (P>0.05). On the day before surgery the values of FVC and FEV1 were increased (more in Group-I who were treated with bronchodilator) and 7th postoperative day the values were decreased (more in Group-II who were not treated with bronchodilator). The results were found statistically significant in between groups (P<0.05). Conclusion: Bronchodilator should be considered pre-operatively in all patients having impaired pulmonary function undergoing off-pump CABG for better preservation of postoperative pulmonary function. DOI: http://dx.doi.org/10.3329/cardio.v7i2.22260 Cardiovasc. j. 2015; 7(2): 123-127
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Somand, Heather, and Tami L. Remington. "Tiotropium: A Bronchodilator for Chronic Obstructive Pulmonary Disease." Annals of Pharmacotherapy 39, no. 9 (September 2005): 1467–75. http://dx.doi.org/10.1345/aph.1e469.
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OBJECTIVE: To review the scientific literature evaluating the efficacy and tolerability of tiotropium bromide, a new bronchodilator indicated for treatment of chronic obstructive pulmonary disease (COPD). DATA SOURCES: Articles were identified through searches of MEDLINE (1966–January 2005) using the key words tiotropium, BA 679 BR, chronic obstructive pulmonary disease, and anticholinergic agents. Additional citations were identified from bibliographies of publications cited. STUDY SELECTION AND DATA EXTRACTION: Experimental and observational studies of tiotropium bromide were selected. Trials of the efficacy of the drug in humans were the focus of the review. DATA SYNTHESIS: Tiotropium bromide is an effective bronchodilator for patients with COPD. It produces clinically important improvements in lung function, symptoms of dyspnea, quality of life, and exacerbation rates compared with placebo. In comparative studies, tiotropium does not appear to be more efficacious than salmeterol or ipratropium. CONCLUSIONS: Tiotropium is an effective inhaled anticholinergic agent that is recommended among preferred long-acting bronchodilators for the chronic management of moderate to very severe COPD. Although similar to ipratropium in efficacy and tolerability, it has the advantage of once-daily dosing.
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Carswell, F. "Bronchodilator Therapy." Archives of Disease in Childhood 60, no. 3 (March 1, 1985): 291. http://dx.doi.org/10.1136/adc.60.3.291.
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Price, John, and Søren Pedersen. "Bronchodilator Therapy." American Journal of Respiratory and Critical Care Medicine 151, no. 2_pt_2 (February 1995): S26—S27. http://dx.doi.org/10.1164/ajrccm/151.2_pt_2.s26.
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Nemec, Mary Alice, Susan C. Sorrells, Thomas J. Prihoda, and Robert L. Talbert. "An Objective Method of Compliance Assessment with Metered-Dose Inhalers." DICP 23, no. 2 (February 1989): 128–32. http://dx.doi.org/10.1177/106002808902300204.
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Evaluation of compliance with metered-dose inhalers (MDIs) is especially difficult. We investigated the correlation between serial weight change of the MDI canister and the number of doses delivered. Canister weight strongly correlated with number of activations for three different bronchodilators (metaproterenol, r2 = 0.9965; albuterol, r2 = 0.9984; terbutaline, r2 = 0.9913). To validate these results, a one-month trial designed to mimic patient use was conducted. Nine aerosol bronchodilator MDIs (three each of terbutaline, albuterol, and metaproterenol) were evaluated by three volunteers, each given one of each type of MDI. Number of activations were recorded in a diary and canisters were weighed weekly. At the end of the four-week period the number of activations were determined from weekly canister weight. Predicted activation numbers, calculated from both regression line and baseline weight, were compared to actual activation number. Statistical analysis was done using analysis of variance. Predicted number of activations for all three drugs ranged from 77 to 125 percent of observed and did not significantly differ depending on the type of bronchodilator (p = 0.3340). The method of prediction, regression intercept or baseline weight, led to significantly different predictions (p = 0.0569). The interaction between the method of prediction and type of bronchodilator was significant (p = 0.0197). Using either method, the actual number of doses dispensed can be predicted within 25 percent.
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Rivera-Sepulveda, Andrea V., Terri Rebmann, James Gerard, and Rachel L. Charney. "Physician Compliance With Bronchiolitis Guidelines in Pediatric Emergency Departments." Clinical Pediatrics 58, no. 9 (May 23, 2019): 1008–18. http://dx.doi.org/10.1177/0009922819850462.
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An online survey was administered through the American Academy of Pediatrics (AAP) Section of Emergency Medicine Survey Listserv in Fall, 2017. Overall compliance was measured as never using chest X-rays, viral testing, bronchodilators, or systemic steroids. Practice compliance was measured as never using those modalities in a clinical vignette. Chi-square tests assessed differences in compliance between modalities. t tests assessed differences on agreement with each AAP statement. Multivariate logistic regression determined factors associated with overall compliance. Response rate was 47%. A third (35%) agreed with all 7 AAP statements. There was less compliance with ordering a bronchodilator compared with chest X-ray, viral testing, or systemic steroid. There was no association between compliance and either knowledge or agreement with the guideline. Physicians with institutional bronchiolitis guidelines were more likely to be practice compliant. Few physicians were compliant with the AAP bronchiolitis guideline, with bronchodilator misuse being most pronounced. Institutional bronchiolitis guidelines were associated with physician compliance.
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Lesmana, Andrean, Amira Permatasari Tarigan, and Fajrinur Syarani. "Effectiveness of administration of bronchodilator by spacers, home-made spacers and nebulizers in patients with chronic obstructive pulmonary disease." International Journal of Research in Medical Sciences 7, no. 6 (May 29, 2019): 2417. http://dx.doi.org/10.18203/2320-6012.ijrms20192540.
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Background: In chronic obstructive pulmonary disease (COPD), bronchodilator therapy using dry powder inhaler (DPI) or a measured dose inhaler (MDI) is more convenient at a lower cost than nebulizer therapy. Mistakes in the use of MDI often occur due to lack of coordination but with the addition of spacers, drawbacks in the use of this MDI can be overcome so that it does not require coordination. Commercial spacers are relatively expensive and not available anywhere while home-made spacers made from bottles of mineral water are very cheap and can be made alone. Study aimed to evaluate the effectiveness of each device, namely a spacer, a home-made spacer and nebulizer.Methods: This study is an experimental study of 62 COPD patients who received bronchodilators using spacers, home-made spacers, and nebulizers. Spirometry is performed for each sample before and after bronchodilator administration to assess FEV1, KVP and changes in VAS dyspnea. The difference in the effectiveness of bronchodilators for various devices in COPD patients was statistically analyzed using the ANOVA test.Results: There were significant differences in the values of VEP1, KVP and VAS dyspnoea after bronchodilator administration through the spacer, home-made spacer and nebulizer (p<0.001), (p=0.002), (p<0.001). The increase in% VEP1 with a nebulizer device was higher than that of a spacer (p=0.001) and the increase in% VEP1 with the nebulizer device was also significantly significant compared to home-made spacer (p<0.001). The increase in% KVP with the nebulizer device was higher than that of home-made spacer (p<0.001), as well as between spacers and home-made spacers and this was significant (p=0.038). The decrease in VAS dyspnoea in patients using nebulizer device than the spacer (p<0.001). Decreasing VAS dyspnoea with nebulizer devices is higher compared to home-made spacers, also gives significant results (p<0.001). There were no differences in the decrease in VAS dyspnoea between spacers and home-made spacers.Conclusions: The administration of bronchodilators by use of three devices (spacers, home-made spacers and nebulizers) can significantly increase the values of FEV1, KVP and VAS dyspnoea. On the use of spacers and home-made spacers, the increase of pulmonary physiological values is not significantly different.
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Abdel-Kader, Maged S., Najeeb U. Rehman, Abdullah F. Aldosari, Fahad S. Almutib, Ali I. Al Muwinea, and Abdulaziz S. Saeedan. "Bronchodilator Secondary Metabolites from Rhazya stricta Decne Aerial Parts." Separations 9, no. 12 (December 6, 2022): 412. http://dx.doi.org/10.3390/separations9120412.
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The plant kingdom comprises medicinally useful plants that have provided many new drugs used to treat various diseases. In our search for bronchodilator secondary metabolites from plants growing in Saudi Arabia, the total extract of Rhazya stricta showed activity against carbamylcholine- (CCh) induced bronchoconstriction in guinea pig tracheal muscles used as an ex vivo model. The fractions obtained from liquid–liquid extraction process were tested for bronchodilator effects. The most active ethyl acetate fraction (RS-E) and aqueous fraction (RS-H) were subjected to biologically guided phytochemical study using different stationary phases and chromatographic techniques to isolate the pure secondary metabolites. Five known compounds were isolated from the active fractions. Three alkaloids namely; (-)-quebrachamine (1), (+)-eburenine (2), (+)-stemmadenine (3) as well as the two iridoid glycosides loganic acid (4) and loganine (5) were identified by various spectroscopic methods. Among the isolated compounds 1 and 5 were the only active as bronchodilators in the plant. It is worth to mention that iridoid glycosides are isolated for the first time from R. stricta.
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Sharova, N. V., S. L. Grishaev, D. V. Cherkashin, S. V. Efimov, M. A. Kharitonov, A. I. Zakharova, and I. M. Zakharova. "Early bronchodilatory response to the first dose of indacaterol/glycopyrronium as an additional individual predictor of their effectiveness in the treatment of chronic obstructive pulmonary disease." Bulletin of the Russian Military Medical Academy 22, no. 4 (December 15, 2020): 17–22. http://dx.doi.org/10.17816/brmma62798.
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The effectiveness of the early bronchodilatory response of the first dose of a fixed double combination of long-acting bronchodilators of various classes indacaterol/glycopyrronium and long-acting anticholinergics glycopyrronium and Tiotropium in patients suffering from stable chronic obstructive pulmonary disease is compared. It was found that in all patients included in the study and suffering from chronic obstructive pulmonary disease, changes in functional respiratory indicators were accompanied by positive and comparable dynamics of clinical signs: a decrease in the severity of shortness of breath, the impact of the disease on the quality of life and increased tolerance to physical activity. It was found that the combination of indacaterol/glycopyrronium provides rapid, pronounced and prolonged bronchodilation in patients suffering from chronic obstructive pulmonary disease compared to the separate use of glycopyrronium and Tiotropium. Consistent use of glycopyrronium and salbutamol leads to maximum bronchodilation, which makes it advisable to separate the use of prolonged bronchodilators when initiating therapy for chronic obstructive pulmonary disease. Therefore, there is a clinical feasibility of taking not only fixed combinations of bronchodilators of different classes, but also their consistent use. The results of an early bronchodilatory response to the first dose of indacaterol/glycopyrronium can be used as an additional individual predictor of their effectiveness in the treatment of chronic obstructive pulmonary disease.
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Lipworth, Brian J., and Catherine M. Jackson. "Bronchodilator Reversibility to Albuterol Predicts Bronchodilator Response to Salmeterol." Chest 121, no. 4 (April 2002): 1382. http://dx.doi.org/10.1378/chest.121.4.1382.
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Demey, Lucas, Alain Van Muylem, Andrei Malinovschi, Amaryllis Haccuria, Silvia Perez-Bogerd, and Alain Michils. "Exploring the sites and kinetics of bronchodilator response to β-2 agonists in asthma." Journal of Applied Physiology 130, no. 4 (April 1, 2021): 1106–13. http://dx.doi.org/10.1152/japplphysiol.00643.2020.
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FEV1 increase usually observed after tHe inhalation of short-acting β2-agonists in asthma patients tends to involve peripheral airways. This study shows that the heterogeneity of responses to short-acting β2-agonists in asthma not only involves distinct sites of bronchodilation, but also distinct sequences between these sites. This indicates that a detailed understanding of the bronchodilator effect of β2-agonists in asthma should not be limited to studying its early impact on FEV1.
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Mahler, Donald A. "Pro: Inhaled corticosteroids for chronic obstructive pulmonary disease." Journal of Precision Respiratory Medicine 2, no. 1 (December 1, 2019): 35–40. http://dx.doi.org/10.2500/jprm.2019.190008.
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Background: Controversy exists about the use of inhaled corticosteroids (ICS) in patients with chronic obstructive pulmonary disease (COPD). Although ICS are not approved as monotherapy for COPD, four ICS molecules, beclomethasone, budesonide, fluticasone furoate, and fluticasone propionate, are used widely in combination with long-acting bronchodilators to treat patients with this disease. Objectives: (1) To review the mechanisms of action of ICS therapy that contribute to the clinical benefits in COPD; and (2) to describe improvements in lung function, relief of dyspnea, increase in exercise tolerance, and the reduction in exacerbations with ICS use in COPD. Methods: A critical review of phase III and IV randomized clinical trials that evaluated ICS therapy in patients with COPD. Results: ICS have two major mechanisms of action in human airways: a reduction in edema and inflammation, and a decrease in airway hyperresponsiveness. ICS monotherapy significantly increases the morning peak expiratory flow rate and forced expiratory volume in 1 second (peak and trough) as early as the first day of treatment. Discontinuation of ICS therapy leads to deterioration in lung function. Treatment with ICS, alone and in combination with a long-acting bronchodilator, reduces dyspnea related to daily activities, whereas withdrawal increases breathing difficulty. Patients with COPD exhibit a significant increase in exercise duration with ICS therapy. The combination of ICS with one or more bronchodilators significantly reduces the exacerbation rate compared with bronchodilator therapy alone. The major serious adverse effect is an increased risk of pneumonia. Conclusion: Randomized controlled trials demonstrate that ICS therapy improves both physiologic and clinical outcomes in patients with COPD. These benefits are enhanced when ICS molecules are combined with one or more long-acting bronchodilators.
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O'Byrne, Paul, Lauren Cuddy, D. Wayne Taylor, Stephen Birch, Joanne Morris, and Jerry Syrotuik. "Efficacy and Cost Benefit of Inhaled Corticosteroids in Patients Considered to Have Mild Asthma in Primary Care Practice." Canadian Respiratory Journal 3, no. 3 (1996): 169–75. http://dx.doi.org/10.1155/1996/105967.
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OBJECTIVE:Inhaled corticosteroids are infrequently used as asthma therapy in patients considered to have mild asthma in primary care practice. The purpose of this study was to determine whether the use of low doses of inhaled corticosteroids (budesonide), supplemented with bronchodilators as needed, provides clinical benefit and is cost beneficial compared with therapy with bronchodilators alone, in patients considered by their physicians in a primary care setting to have mild asthma, not requiring inhaled corticosteroids.DESIGN:Double-blind, randomized controlled study comparing three parallel treatment groups receiving 400 mg or 800 mg inhaled budesonide/day or placebo.SETTING:Seven primary care practices across Canada.PATIENTS:Fifty-seven adult asthmatics considered to have mild asthma not needing inhaled corticosteroids.OUTCOME MEASURES:Patients recorded morning and evening peak expiratory flow rates (PEFR) and daily asthma symptom scores. Economic data were collected regarding drug and service use and willingness to pay.RESULTS:Budesonide significantly reduced early morning and nocturnal symptoms and sputum production, and reduced the use of a bronchodilator compared with placebo. The budesonide groups also showed significant improvements in PEFR, before and after bronchodilator. No differences were found between the two dosages of budesonide; however, the study had insufficient power to detect differences between dosages, had they been present. There was a similar frequency of adverse events in all three treatment groups. The willingness-to-pay assessment found that both doses of budesonide were more cost beneficial than placebo.CONCLUSIONS:These results demonstrate that inhaled budesonide 400 mg/day provides better asthma control and is cost beneficial compared with bronchodilators alone in the management of patients with mild asthma who were not considered to need inhaled corticosteroids in primary care practice.
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Goedhart, Dick M., and Pieter Zanen. "Selecting the best method to evaluate bronchodilation when analysing bronchodilator studies." Statistics in Medicine 21, no. 23 (November 11, 2002): 3677–85. http://dx.doi.org/10.1002/sim.1309.
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Ghosh, Arnab, Cynthia J. Koziol-White, Kewal Asosingh, Georgina Cheng, Lisa Ruple, Dieter Groneberg, Andreas Friebe, et al. "Soluble guanylate cyclase as an alternative target for bronchodilator therapy in asthma." Proceedings of the National Academy of Sciences 113, no. 17 (April 11, 2016): E2355—E2362. http://dx.doi.org/10.1073/pnas.1524398113.
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Asthma is defined by airway inflammation and hyperresponsiveness, and contributes to morbidity and mortality worldwide. Although bronchodilation is a cornerstone of treatment, current bronchodilators become ineffective with worsening asthma severity. We investigated an alternative pathway that involves activating the airway smooth muscle enzyme, soluble guanylate cyclase (sGC). Activating sGC by its natural stimulant nitric oxide (NO), or by pharmacologic sGC agonists BAY 41–2272 and BAY 60–2770, triggered bronchodilation in normal human lung slices and in mouse airways. Both BAY 41–2272 and BAY 60–2770 reversed airway hyperresponsiveness in mice with allergic asthma and restored normal lung function. The sGC from mouse asthmatic lungs displayed three hallmarks of oxidative damage that render it NO-insensitive, and identical changes to sGC occurred in human lung slices or in human airway smooth muscle cells when given chronic NO exposure to mimic the high NO in asthmatic lung. Our findings show how allergic inflammation in asthma may impede NO-based bronchodilation, and reveal that pharmacologic sGC agonists can achieve bronchodilation despite this loss.
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Melo, Saulo Maia d'Avila, Larissa Alves de Oliveira, Rodrigo dos Anjos Rocha, and José Lucas Farias Wanderley. "Bronchodilator test in extreme old age: Adverse effects of short-acting beta-2 adrenergic agonists with clinical repercussion and bronchodilator response." Revista da Associação Médica Brasileira 65, no. 11 (November 2019): 1343–48. http://dx.doi.org/10.1590/1806-9282.65.11.1343.
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SUMMARY OBJECTIVE: To evaluate chronological age as a limiting factor to perform the bronchodilator test, determine significant adverse effects of short-acting beta 2 agonists with clinical repercussions, and assess bronchodilator response in extreme-old-age patients who undergo the spirometry test. METHODS: This is a cross-sectional and retrospective study. The sample was extracted from the database (spirometer and respiratory questionnaire) of a pulmonary function service. Patients over 90 years old were included in the research, and we evaluated their bronchodilator response and its significant adverse effects that may have clinical repercussions related to the bronchodilator. RESULTS: A sample of 25 patients aged 92.12 ± 2.22 years (95% CI, 91.20 - 93.04), with a minimum age of 90 years and a maximum of 97 years and a predominance of females with 72% (18/25). The bronchodilator test was performed in 84% (21/25) of the patients. The bronchodilator response was evaluated in 19 of the 21 patients (90.47%) who underwent the bronchodilator test. Two tests did not meet the criteria of acceptability and reproducibility. No clinical adverse effects were observed with the bronchodilator medication (salbutamol) during or after the exam. CONCLUSIONS: Chronological age is not a limiting factor for the bronchodilator test, short-acting beta-2 agonists did not present adverse effects with significant clinical repercussion and were useful in the diagnosis and therapeutic guidance of extreme-old-age patients.
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Jizar, Alaa, Zeinab Hashim, and Ahmed Jasim. "Role of Forced Expiratory Volume in Third second (FEV3) as An Alternative to Forced Vital Capacity (FVC) in Assessing Bronchodilator Response in Patients with Chronic Obstructive Airway Diseases." Iraqi Journal of Medical Sciences 18, no. 2 (December 31, 2020): 94–100. http://dx.doi.org/10.22578/ijms.18.2.2.
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Background: Spirometry is a physiological procedure used as a diagnostic tool for disease diagnosis; e.g. obstructive pulmonary diseases such as asthma or chronic obstructive pulmonary disease (COPD). The bronchodilator test is a method of measuring lung capacity changes following inhalation of a short-acting bronchodilator drug that dilates the airway, this test helps to diagnose, evaluate and differentiate asthma from COPD. Objective: To evaluate the role of forced expiratory volume in third second (FEV3) as an alternative for forced vital capacity (FVC) in assessing bronchodilator response in patients with chronic obstructive airway diseases. Methods: The study a case-control, comparative study done from November 2018 to November 2019. The cases involved divided into 2 groups; patients group included (80) patients with chronic obstructed pulmonary diseases (asthma and COPD) and control group included (160) apparently healthy peoples aged and sex matched. Lung function was measured using a standard protocol and electronic table spirometry. Bronchodilator test was done for each patient with chronic obstructed defect on spirometer. Results: There was no significant difference between (FVC), FVC% and (FEV3), FEV3% respectively before bronchodilator and there was no significant difference after bronchodilator in patients. There was no significant difference between FEV1/FVC, FEV1/FVC % and FEV1/ FEV3, FEV1/FEV3% respectively before bronchodilator and there was no significant difference after bronchodilator in patients. Conclusion: FEV3 can be used as an alternative to FVC in patients with chronic obstructive airway diseases for assessing bronchodilator response. Keywords: Spirometry, Bronchodilator test, FVC%, FEV3%, FEV1/FVC%, FEV1/FEV3% Citation: Jizar AY, Hashim ZH, Jasim AH. Role of forced expiratory volume in third second (FEV3) as an alternative to forced vital capacity (FVC) in assessing bronchodilator response in patients with chronic obstructive airway diseases. Iraqi JMS. 2020; 18(2): 94-100. doi: 10.22578/IJMS.18.2.2
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Kim, Jung Won, and Eun Young Park. "Self-management of oxygen and bronchodilators to relieve the dyspnoea of lung cancer with pneumoconiosis." International Journal of Palliative Nursing 26, no. 4 (April 2, 2020): 167–74. http://dx.doi.org/10.12968/ijpn.2020.26.4.167.
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Objective: This study aimed to evaluate the level of dyspnoea and the self-management strategies used to alleviate dyspnoea in lung cancer patients with concurrent pneumoconiosis, particularly oxygen therapy and bronchodilator treatment. Furthermore, the authors aimed to determine the factors associated with such self-management and to provide a basis for developing an applicable and safe treatment plan for alleviating dyspnoea. Method: This study involved a cross-sectional survey. Data were collected using self-report questionnaires from 79 participants between January and July 2016, and self-management strategies were analysed using analysis of variance and multiple logistic regression analysis. Results: In terms of the self-management practices employed to relieve dyspnoea, 53.2% of the patients adjusted their oxygen intake and 70.9% used bronchodilators over the prescribed dosage. Adjusting the oxygen intake was not significantly associated with any of the patient characteristics. The factors related to increased bronchodilator use were the presence of comorbidities, cardiopulmonary function, subjective respiratory distress, activities of daily living, and the number of prescribed bronchodilators. Conclusion: Dyspnoea is a severe critical condition, and urgent management of its clinical symptoms is required. Healthcare professionals who care for patients with lung cancer with pneumoconiosis should pay attention to the dyspnoea and manage it based on clinical evidence. Development of customised, integrated nursing treatment plans is needed to alleviate dyspnoea in patients with complications and chronic dyspnoea who have low daily activity levels.