Biomedical subjects
K N Leifer
Publications and source records attributed to K N Leifer.
Flunisolide aerosol in the treatment of perennial allergic rhinitis.
A double-blind, crossover study was performed with a new topical aerosol steroid, flunisolide, administered every 12 hours over a period of eight weeks to 36 adult patients with perennial allergic rhinitis. During the treatment period the majority of patients had significant relief of symptoms as compared with the placebo period. Most prominent improvement occurred with the symptoms of nasal stuffiness, sneezing, rhinorrhea and the number of times patients had to blow their noses. Best results were obtained in patients with higher degrees of atopy. Side effects were minimal and limited to nasal irritation in some patients. Criteria for optimal patient selection are discussed and an explanation for the lack of systemic effects of aerosolized use of the newer corticosteroids is given.
Differing patterns of pulmonary function response to bronchodilators in asthmatics.
An analysis of the patterns of pulmonary function response to bronchodilators in 20 adult asthmatics reveal distinct categories of response. It is suggested that the pattern of response is related primarily to the degree of baseline abnormality in pulmonary function rather than to other characteristics of the disease or patient. Thus, one may predict pulmonary function response to bronchodilators in adult asthmatics based solely upon baseline function.
Unreliability of maximum mid-expiratory flow rate as sole index of bronchodilator response in chronic asthma.
Analysis of individual patterns of response to bronchodilation in asthmatics, rather than group averages, emphasizes the varying types of "asthma" as well as the need to examine all parameters of lung function when evaluating any new therapeutic agent. The often praised maximum mid-expiratory flow rate may be very misleading as a parameter of drug response.
Spirometric comparison of carbuterol and isoproterenol aerosol therapy in bronchial asthma. A double blind, matched-pair study of 28 adults and a double blind crossover study of 18 children.
Two adrenergic aerosols were compared in a double blind, matched-pair study of 6 months' duration in 28 adult patients with chronic bronchial asthma, and in a double blind, crossover, short-term study in 18 children with severe asthma. In the adult study, one member of each pair was given either 150 mug of isoproterenol or 200 mug of carbuterol 4 times per day, by inhalation, for 6 months. In the childhood study, 18 children, 6 to 12 years of age, with moderate to severe asthma were studied in a double blind, crossover therapeutic trial in which high or low doses of aerosolized carbuterol or isoproterenol were given 4 times daily for 5 days each. Treatment results were evaluated by measuring forced vital capacity, 1-sec forced expiratory volume, and maximal mid-expiratory flow (FEF25-75%) at regulat intervals before and after administration of the respective test drugs. In the adult study, there was a significant difference between carbuterol and isoproterenol for forced vital capacity (P less than 0.02), for 1-sec forced expiratory volume (P less than 0.02), and for FEF25-75% (P less than 0.01) in favor of carbuterol. In the pediatric study, the difference between carbuterol and isoproterenol was significant (P less than 0.05) only for the FEF25-75% on the fifth day of treatment with the high dose administration of carbuterol. There was no associated toxicity of either drug with respect to electrocardiogram, blood chemistry, or subjective complaints. Tachyphylaxis (tolerance with time) to isoproterenol appeared to develop in one patient.
Letter: A comment on arterial PO2--a clinically irrelevant value.
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Suppression of histamine-induced pruritus by three antihistaminic drugs.
A double-blind crossover study of inhibition of histamine-induced pruritus by three commonly prescribed antihistamines was conducted on 28 normal subjects. Drugs used included diphenhydramine HCl (Benadryl), cyproheptadine (Periactin), hydroxyzine HCl (Atarax), and a lactose placebo in identical capsules. Intradermal histamine dose-response thresholds of pruritus were obtained before and after pretreatment with the three antihistamines and placebo in each subject. Analysis of data revealed a fivefold increase above baseline of the histamine dose required to produce pruritus following both cyproheptadine and placebo. This compared to a tenfold increase following diphenhydramine and a 750-fold increase following hydroxyzine HCl. The most common side effect was drowsiness, which occurred with all three drugs.
Annals of allergy.
A review of the world literature regarding the relative efficacy, duration and toxicity of the available beta-adrenergic bronchodilator aerosols for the treatment of asthma is presented. Many of these agents will soon become available in the United States and some familiarity with their actions is necessary for optimal care of asthmatic patients.