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Biomedical subjects

A Muittari

Publications and source records attributed to A Muittari.

At least 19 recordsLinked to original sources
PubMed1989

The superiority of combination beclomethasone and salbutamol over standard dosing of salbutamol in the treatment of chronic asthma.

We studied the clinical effect of a combination aerosol containing salbutamol and beclomethasone dipropionate in comparison to doubling the standard dose of salbutamol from an inhaler. Fifty-seven patients completed the double-blind, crossover study. They were treated with either an aerosol of 100 micrograms beclomethasone dipropionate and 200 micrograms salbutamol or 400 micrograms salbutamol alone. Both regimens were administered four times a day for 4 weeks. The patients showed significant improvement in FEV1, PEFR, and symptom scores after treatment with beclomethasone dipropionate and salbutamol compared with pre-trial values and with treatment with double the dose of salbutamol. The patients demonstrated a clear preference for treatment with the combination of beclomethasone dipropionate and salbutamol. Regular treatment with beclomethasone dipropionate in addition to salbutamol as a combination inhaler provides much better control of asthma than merely increasing the dose of salbutamol in those patients poorly controlled on standard doses of inhaled bronchodilators.

Adolescent↗
PubMed1988

Methacholine bronchial challenge using a dosimeter with controlled tidal breathing.

A new inhalation synchronised dosimeter triggered by low inspiratory flow rates has been assessed. The methacholine challenge test using dosimeter nebulisation with controlled tidal breathing was compared with continuous nebulisation using De Vilbiss No 40 nebulisers with deep inhalations in 11 asthmatic subjects. Within subject PD20 FEV1 values were lower with the dosimeter method than with the continuous nebulisation method (geometric means 158 and 588 micrograms). The repeatability of the dosimeter method with controlled tidal breathing was studied in 11 asthmatic subjects, and the 95% range for a single measurement was +/- 0.72 doubling doses of methacholine. The dosimeter method has greater efficacy because aerosol is delivered during the first part of an inhalation, minimising loss of aerosol outside the respiratory tract. The dosimeter technique combined with controlled tidal breathing appears to be a useful method for carrying out standardised non-specific bronchoprovocation tests.

Adolescent↗
PubMed1987

Aerosol deposition in automatic dosimeter nebulization.

A new dosimeter nebulization method was studied in 10 asthmatics and 8 normal volunteers by delivering fixed doses of 99mTc-traced radioaerosol in 0.2 s periods of tidal breathing. Two separate inspiratory phases were studied with the onset of nebulization, when in the earlier phase 15% and in the later phase 60% of tidal volume was inhaled. Further, bronchodilator administration was analogically assessed in the asthmatics. In healthy subjects, the total lung deposition was 17% greater in the earlier phase (p less than 0.005) than in the later one. In asthmatics, the difference was not significant. The losses of aerosol outside the lower respiratory tract were minimized, in the mouthwashing 0.3% and in the exhaled air 1.4%. The onset of nebulization (early or late) had no significant effect on bronchodilation with salbutamol in asthmatics. We conclude that the present dosimeter method is useful for efficient delivery of radioaerosols and drugs, and for standardization of bronchoprovocation.

Adult↗
PubMed1986

Bronchodilator effects of a fenoterol metered dose inhaler and fenoterol powder in asthmatics with poor inhaler technique.

Thirty-seven per cent of 204 consecutive asthmatic patients using metered dose inhalers (MDI) regularly had faulty inhaler technique. Twenty patients with poor technique volunteered for bronchomotor tests. The bronchodilator effects of 0.2 mg of fenoterol in MDI form, 0.2 mg of fenoterol in powder form and a placebo powder were compared. Mean peak expiratory flow (PEF) and forced expiratory volume in 1 s (FEV1) values after 0.2 mg of fenoterol in MDI form were only slightly different from those after placebo. Inhalation of 0.2 mg of fenoterol powder was, however, followed by a highly significant (p less than 0.001) increase in measured expiratory indices. PEF and FEV1 values were significantly higher after fenoterol powder than after fenoterol in MDI form (PEF, p less than 0.01 at 5 min, p less than 0.001 at 15 min, and p less than 0.05 at 60 min, FEV1, p less than 0.01 1 h after drug administration). Poor MDI technique can severely impair the effect of bronchodilator drugs. Use of a bronchodilator in powder form is more reliable in these patients.

Adolescent↗
PubMed1982

Effects of acute and long-term bronchodilator treatment on regional lung function in asthma assessed with krypton-81m and technetium-99m-labelled macroaggregates.

We have investigated the effect of acute and long-term bronchodilator treatment on the distribution of ventilation and perfusion in 15 asthmatics using a gamma camera, krypton-81m (for ventilation) and technetium-99m macroaggregate (for perfusion). Individual peak expiratory flow (PEF) values before bronchodilation were slightly or moderately below the predicted values. The simultaneous ventilation images (analysed visually) showed areas of delayed ventilation in all patients (mean distribution score on 3-point scale 2.1). After isoprenaline inhalation (240 micrograms) the mean PEF increased by 24%, but the distribution of ventilation remained virtually unchanged in all patients (mean score 2.0). Simultaneously defects in perfusion could be seen in all patients (mean score 1.5). After intensive treatment, when the mean PEF increased by a further 29%, the distribution scores of ventilation and perfusion fell to 0.8 and 0.9, respectively. The results indicate that, without intensive and long-term treatment, appreciable inequality of ventilation and perfusion are usual consequences of asthma; and suggest that although larger airways are dilated by isoprenaline inhalations residual bronchial obstruction may still remain in some smaller airways, maintaining uneven distribution. Perfusion disturbances seem to be secondary to changes in regional ventilation.

Adult↗
PubMed1979

Objective and subjective assessment of ephedrine combinations in asthmatic outpatients.

11 asthmatic outpatients were treated with placebo, ephedrine + theophylline + hydroxyzine, ephedrine + theophylline, and ephedrine + hydroxyzine, orally t.i.d. for 4 days each in random order. Both objective (PEF rates) and subjective (ranking list) assessments demonstrated the efficacy of the triple combination over placebo. The combination of two drugs proved objectively or subjectively somewhat less acceptable.

Adolescent↗
PubMed1978

The effect of ICI 74,917 on asthma and bronchial provocation tests.

A study was made of the protective action of the anti-allergic drug ICI 74,917, a phenanthroline derivative, in specific allergen provocation tests and in combating clinical symptoms in thirteen asthmatic out-patients. It was found that ICI 74,917 was able to diminish allergen-induced bronchoconstriction significantly (P less than 0.01) during both the placebo period and during chronic treatment with ICI 74,917 for 4 weeks. The results obtained during these two periods did not differ significantly. There was not, however, any statistically significant difference in the symptom scores or PEF rates during the treatment with ICI 74,917 or placebo for 1 month. This may indicate that although ICI 74,197 is able to prevent bronchoconstriction in an allergen provocation test, it failed to improve asthma clinically. No signs of the phenomenon of tachyphylaxis were observed in the present study. The Student's t-test was used in the statistical analysis.

Adolescent↗
PubMed1978

A comparison of rimiterol and salbutamol by inhalation at high and low dose in asthmatic patients.

Rimiterol hydrobromide (Pulmadil) has been shown to have a dose-related bronchodilator effect; the optimum dose by inhalation appears to lie between 200 and 1,000 microgram. When given to a group of asthmatic patients at 'recommended' and 5--10 times 'recommended' dose by aerosol, cardiovascular effects were minimal and of a magnitude similar to that of salbutamol given in the same dosages to the same patients. The very rapid bronchodilator effect of rimiterol would appear to make the drug particularly suitable for the treatment of patients with intermittent asthmatic attacks, before exercise in patients with exercise-induced asthma and for bronchodilatation before using inhaled sodium cromoglycate or corticosteroid aerosols.

Aerosols↗
PubMed1978

A brief review of sympathomimetic bronchodilators and a description of a new selective agent, rimiterol hydrobromide.

The development of beta2-specific sympathomimetic bronchodilators (rimiterol, salbutamol, terbutaline) has made the basic treatment of asthmatic patients more safe and effective. Despite that, the asthmatics should be under careful control and all patients should be taught the correct way to use their bronchodilator aerosols. If a sympathomimetic drug has lost its effectiveness, the patient should be able to have easy contact to the treating physician or outpatient department.

Adrenergic beta-Agonists↗
PubMed1978

Correlation of RAST and provocation tests for diagnosing allergic asthma and rhinitis.

252 bronchial (BPT) and 346 nasal (NPT) provocation tests were done. A positive RAST coincided with a positive BPT in 81% and a positive NPT in 82% of the cases. When RAST was negative the BPT's were positive in 33% and NPT's in 54% of trials. Contrary to the NPT's the RAST and the BPT's agreed well in different allergen groups, excepting mold provocation.

Allergens↗
PubMed1978

Natural and synthetic fibers as causes of asthma and rhinitis.

One hundred and thirty-six textile workers were tested with natural fibers; 97 were tested with synthetic fibers. By inhalation testing 20% were positive to both types of fibers; by nasal provocative testing 30% were positive. There was a close correlation between the size of the wheals in the prick tests and the percentage of fiber challenge tests. Fiber provocation tests and metacholine tests did not display any conformity with each other. The authors feel that synthetic fibers may act as haptens and cause Type I or IgE-mediated allergy and both natural and synthetic fibers should be considered important causes of occupational asthma among textile workers.

Adolescent↗
PubMed1976

Effect of salbutamol inhalations of plasma and urinary cyclic adenosine monophosphate levels in asthmatics and non-atopic controls.

Twenty asthmatics and 14 non-atopic controls were given long-acting theophylline tablets, 400 mg twice daily, and were then challenged, after a control period, with 0.5 mg salbutamol as an inhalant, divided in two doses. Urinary and plasma cyclic adenosine monophosphate (cAMP) levels were determined at the beginning of the study, during theophylline treatment and after the challenge with salbutamol inhalation. In neither the asthmatics nor the controls did theophylline alone raise the concentration of cAMP in plasma or its excretion in urine. Inhalation of salbutamol caused a significant rise in plasma cAMP levels in the controls but not in asthmatics. The inhaled sympathomimetic aerosol caused a slight simultaneous rise in urinary cAMP excretion in non-atopic controls, but in the asthmatics. Our results show that sympathomimetics administered directly to the bronchial mucosa do not elicit the same metabolic cAMP response in asthmatics as in controls.

Administration, Oral↗