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Biomedical subjects

I Ziment

Publications and source records attributed to I Ziment.

At least 19 recordsLinked to original sources
PubMed1991

History of the treatment of chronic bronchitis.

Although chronic bronchitis was first named and described in 1808, the disease has been known since earliest time, and numerous drugs have been utilized in its therapy. The basic historic theories of human function have readily been applied to bronchitis; thus in Greek medicine, the disease was appreciated as one of excess phlegm. Early remedies included garlic, pepper, cinnamon, and turpentine, whereas later therapies of choice emphasized coffee, ipecac, and potassium nitrate. Most of the favored bronchodilator drugs of today are derived from the traditional folk remedies, ephedrine, atropine, and theophylline. The most interesting historical drugs, however, are those that have given rise to modern mucokinetic agents such as bromhexine and iodides.

Bronchitis↗
PubMed1990

Risk/benefit ratio of long-term treatment with beta 2-adrenoceptor agonists.

Optimal control of chronic obstructive airway disorders is usually achieved with therapy based on beta 2-adrenoceptor agonist administration. Aerosols are highly effective, have few side effects, allow for fine adjustment of dosage to titrate symptoms, and result in reduction in hyperreactivity. Equivalent bronchodilating doses of oral agents cause side effects that limit acceptability. With oral agents, cardiohemodynamic disturbances are usually minor, while tremor and restlessness diminish with continued drug use. In chronic regimens, an aerosol beta 2-adrenergic agent should be chosen whose overall incidence of side effects is less than 5%, and an oral agent that produces no more than a 10% incidence of tremor. Suboptimal oral dosages in combination with maximal dosages of beta 2-agonist aerosol, with or without other bronchodilator drugs, are advisable for chronic therapy. An optimal risk/benefit ratio with broxaterol therapy will probably be achieved by using an aerosol-oral combination. Thus, broxaterol, a new beta 2-agent, should be studied further to determine its value in chronic bronchospastic disorders.

Adrenergic beta-Agonists↗
PubMed1990

Pharmacologic therapy of obstructive airway disease.

The pharmacologic treatment of chronic obstructive pulmonary disease (COPD) differs from that of asthma in several respects. Oral therapy should be the keystone, using a long-acting theophylline or a beta 2-sympathomimetic agent. The addition of a metered dose inhalant aerosol provides additive benefit with low toxicity; either a sympathomimetic agent or ipratropium or both should be used. The antiinflammatory aerosols, cromolyn, and steroid drugs are usually of no value, and oral steroids are only indicated if there is an asthmatic component. Mucokinetic agents and antibiotics should be used selectively. The numerous other drugs that may be required by a COPD patient must be prescribed with consideration to the potential for adverse physiologic effects and untoward drug interactions.

Adrenal Cortex Hormones↗
PubMed1989

Broxaterol: therapeutic trials and safety profile.

The efficacy and the safety profile of broxaterol have been assessed in multicenter open studies and in some double-blind controlled clinical trials. Broxaterol (0.6-1.2 mg/day by metered dose inhaler or 0.5-1.5 mg/day orally, from 2 weeks to 1 year) produced a significant clinical improvement, an increase in FEV1 and a decrease in supplemental anti-asthmatic drugs used in patients with reversible airflow obstruction and in asthmatic children. The increases in FEV1 versus baseline were significantly maintained after the end of the treatment. Prompt disappearance of the asthmatic attack with significant improvement in lung function was observed in children. In two long-term controlled trials the respiratory effects of broxaterol nebulizer solution were significantly greater than placebo. Moreover, broxaterol by metered dose inhaler was more effective than salbutamol after 3 months follow-up, showing absence of tachyphylaxis. In long-term clinical evaluation, broxaterol has been shown to be well tolerated, with an incidence of adverse reactions equal to or less than that reported in the literature for other beta 2-agonists. The side effects most frequently associated with broxaterol were tremor, nervousness and palpitations. They usually appeared to be slight, transient and dose-related, requiring withdrawal from clinical trials in only 12 patients out of 274 (4.4%). Clinically relevant changes in heart rate and blood pressure were never reported. Broxaterol was found not to modify the ECG or haematological, hepatic and renal laboratory tests. No metabolic abnormalities or hypokalemia were caused by long-term treatment with broxaterol.

Adrenergic beta-Agonists↗
PubMed1988

Acetylcysteine: a drug that is much more than a mucokinetic.

Acetylcysteine is the most widely used mucolytic drug, and it has greater documentation of effectiveness than any other mucokinetic agent. Originally it was used as an aerosol, but currently it is mostly prescribed by the oral route. In addition to the lytic activities of acetylcysteine, the aerosolized drug has bronchorrheic effects, while oral therapy results in expectorant and mucoregulator actions. Newer uses of the drug depend on its effectiveness as a free-radical scavenger, since it is a precursor of glutathione. It is well established as the drug of choice for treating acetaminophen poisoning, and it offers an important role in protecting the lungs from a variety of insults that result in oxidant damage.

Acetylcysteine↗
PubMed1987

Theophylline and mucociliary clearance.

Abnormal mucociliary transport is improvement by the action of theophylline, and this effect can be attributed to several mechanisms. The drug may directly and indirectly mediate the increase in the secretory output of bronchial glands, and this effect is enhanced by the vagal gastropulmonary reflex which is stimulated by the irritant action of theophylline on the stomach. Theophylline can increase the transepithelial secretion of fluid into the respiratory tract lumen by stimulating the chloride pump which is controlled by cyclic AMP. Ciliary motility is stimulated by theophylline; most of this effect is confined to the proximal part of the respiratory tree. However, much of the improvement in mucociliary clearance may be a consequence of the bronchodilation induced by theophylline, since the improved airway patency is generally a prerequisite for enhanced mucokinesis. Nevertheless, the multiple sites of action of theophylline in the respiratory tract suggests that this drug should be considered to be of significant value in any disorder characterized by mucostasis.

Aminophylline↗
PubMed1987

Outpatient management of asthma with regular nebulized beta agonists: comparison of bitolterol mesylate and isoproterenol.

Nebulized bitolterol solution and isoproterenol solution were compared when used on a regular basis, 2.5 mg three times a day for 1 month by patients with chronic asthma. In this multicenter, double-blind trial; 130 nonsteroid-dependent patients were randomized to receive one of the two treatments concomitantly with their regular asthma medications. On study days, at the beginning of the study and after 2 and 4 weeks, treatments were given in the office or laboratory and patients were monitored with pulmonary function tests for eight hours. Both medications induced rapid bronchodilation that had a longer duration after bitolterol. The incidence of tremor was similar with the two medications. Tachycardia and palpitations were more frequent following isoproterenol. Bitolterol has a much longer duration of action and should be considered as a suitable bronchodilator for regular nebulizer treatment of chronic asthma.

Adolescent↗
PubMed1986

Acetylcysteine: a drug with an interesting past and a fascinating future.

N-acetylcysteine (NAC) possesses a free sulfhydryl group that can rupture disulfide bridges. Although it is considered to be a mucolytic, its mucokinetic actions include expectorant, bronchorrheic and mucoregulatory contributions. New uses include the management of acetaminophen poisoning and the scavenging of free radicals liberated by cancer chemotherapy drugs. The antioxidant effects may be of prophylactic value in lungs at risk from smoking, pollution and infection. Other uses proposed for NAC include the therapy of connective tissue diseases and its use as a component in life extension diets.

Acetylcysteine↗
PubMed1986

Respiratory pharmacology. Anticholinergic agents.

Although the anticholinergic agents are among the oldest of all respiratory drugs, they have been used only rarely in recent years. However, newer derivatives may have an important role in the treatment of bronchospastic diseases. The pharmacology of these interesting drugs is reviewed, with an emphasis on the therapeutic role of ipratropium.

Animals↗
PubMed1986

Respiratory pharmacology. Steroids.

Although glucocorticoids are widely used in the treatment and prophylaxis of asthma and other respiratory diseases, questions as to their mechanisms of action and their effectiveness continue to provoke debate. Controversies also exist in the selection of individual steroid preparations, dosages, and methods of delivery. These concerns are examined from the basis of the pharmacologic actions of these potent drugs.

Anti-Inflammatory Agents↗
PubMed1978

A graphic approach to assessing interrelationships among minute ventilation, arterial carbon dioxide tension, and ratio of physiologic dead space to tidal volume in patients on respirators.

A graphic analysis of the relationships among minute ventilation, arterial PCO2, and the ratio of physiologic dead space to tidal volume is presented for the bedside clinical evaluation of patients receiving continuous respiratory support. With simultaneous measurement of minute ventilation and arterial PCO2, the graph can be used to determine the patient's ratio of dead space to tidal volume. This information can subsequently be used (1) for respirator adjustments to obtain the desired arterial PCO2; (2) to assess the severity of ventilation/perfusion unevenness; and (3) to follow the patient's response to respiratory therapy. It provides the clinician with a conceptual tool with which he can assess the status of a patient's gas exchange and more accurately evaluate and plan his course of treatment.

Carbon Dioxide↗