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At least 397 records · Page 22Linked to original sources
PubMed1991

[Psychosomatic study of inhalation therapy in patients with bronchial asthma. II. Relationship between subjective self assessment of dyspnea and peak expiratory flow rates].

The degree of dyspnea when using metered-dose inhalers (MDIs), and the relationship between subjective self assessments and objective peak expiratory flow rates were examined by means of visual analogue scales and mini wright peak flow meters in 16 subjects with asthma. Three subjects who were neurotic in character were found to have a poor perception of the degree of airway obstruction after inhalation compared with objective changes in their condition. Two subjects, one neurotic and one alexithymic, assessed the degree of dyspnea to be worse after inhalation, when objectively there were few changes. However, one neurotic subject perceived an improvement in his condition when, in fact, there was little change. Furthermore, some severe cases used MDIs in the rogressive state of airway obstruction. In conclusion, we must pay attention to patients' characters when determining treatment in order to prevent overuse of MDIs or delays in treatments including the use of MDIs.

Adult↗
PubMed2004

A locally active antiinflammatory macrolide (MLD987) for inhalation therapy of asthma.

One of the characteristic features of asthma is a persistent pulmonary inflammation, with increased numbers of eosinophils and activated T-lymphocytes in the airways. T-helper cells of the Th2 phenotype play a pivotal role in the pathogenesis of asthma, and they are believed to orchestrate the asthmatic response by releasing a wide repertoire of cytokines. Herein, we describe the design, synthesis, and evaluation in models of allergic asthma of a locally active T-cell modulator, MLD987 (1). Compound 1 is a potent immunosuppressant that inhibits the activation, proliferation, and release of cytokines from T-cells with IC(50) values in the low nanomolar range. In a Brown-Norway rat model of allergic asthma, 1, when given into the airways by intratracheal administration (ED(50) = 1 mg/kg) or by inhalation (ED(50) = 0.4 mg/kg), potently reduced the influx of leukocytes into bronchoalveolar lavage fluid samples obtained from antigen-challenged animals. In contrast, 1 had an appreciably weaker activity in this model when given orally or intravenously. Pharmacokinetic evaluation in rat and rhesus monkey showed that 1 had both a low oral (2-4%) and a low pulmonary (7%, monkey) bioavailability. These findings are consistent with a local site of action of the compound and rule out that its antiinflammatory activity in the lung was caused by systemically absorbed material, which had been swallowed during inhalation or which had entered the circulation via the airways. Local administration and the metabolically soft structure of 1, which favors rapid systemic metabolism to less immunosuppressive metabolite 2, are the main reasons for the low exposure and weak systemic activity of the compound. Administration of a locally active compound such as 1, by inhalation, should reduce systemic side effects. Our results indicate that 1 has the potential to serve as an alternative to inhaled glucocorticosteroids for the long-term therapy of asthma of all grades of severity.

Administration, Inhalation↗
PubMed1990

[Inhalation therapy with selective beta 2-sympathomimetic drugs. Effect of pirbuterol administered via the Autohaler and salbutamol administered via the Diskhaler in obstructive respiratory tract disease].

The therapeutic success of salbutamol inhalation with the powder inhalator (Diskhaler) and of pirbuterol with an inhalation-triggered metered aerosol (Autohaler) was determined by comparing the degrees of bronchodilation in 13 patients suffering from chronic obstructive airways disease. Rt and IGV were determined by whole-body plethysmography and FEV1, peak flow and MEF50 by spirometry, and pulse rates were also measured. On average, Rt values decreased by 40 per cent; the other lung function parameters responded correspondingly. Duration of action extended to 4 hours after dosage. Pulse rates and lung functions measured after administration of the products did not differ, either. In such studies as this, whole-body plethysmographic results are superior to those obtained by spirometry.

Adult↗
PubMed1985

Aerosol deposition considerations in inhalation therapy.

Successful aerosol therapy generally depends on the small percentage (typically 10 percent) of the drug dose delivered to the lungs from metered-dose inhalers (MDIs), nebulizers, and dry powder inhalers. Deposition of therapeutic aerosols occurs by inertial impaction (in the oropharynx and large conducting airways) and by gravitational sedimentation (in the small conducting airways and alveoli) and is determined by the mode of inhalation, particle or droplet size, and the degree of airway obstruction. Deposition of metered-dose aerosols in the lungs can be enhanced by using MDIs correctly (aerosol release coordinated with slow, deep inhalation, followed by a period of breath-holding); many patients have poor inhaler technique. Extension devices (spacers and holding chambers) make MDIs easier to use and may increase lung deposition to levels achieved by a correctly used MDI while substantially reducing oropharyngeal deposition. Optimal use of air-driven (jet) nebulizers depends primarily on the choice of nebulizers with relatively small droplet size and on the volume fill and compressed gas flow rate.

Aerosol Propellants↗
PubMed1979

[Inhalation therapy of sinusitis with the Breathing Mask 500].

The subject of this analysis are the results of treatment of sinusitis in its varying forms and degrees with the "Climate Mask 500" in conjunction with antrum puncture. Either dry or humit warm-air inhalations with coniferous oil additives were prescribed depending on the type of sillness. In 100% of the cases so treated normalisation or improvement of the subjective complaint could be observed. The objective findings normalised or improved in 80% of the cases. Because of its therapeutic value, its simplicity, the reduction in medication and the lack of side effects, inhalation treatment with the "Climate Mask 500" can be said to be a useful aid in a causal therapy of sinusitis.

Adult↗
PubMedDate not supplied

Mycoplasma gallisepticum as a model to assess efficacy of inhalant therapy in budgerigars (Melopsittacus undulatus).

One hundred budgerigars (Melopsittacus undulatus) were infected in the nares (0.02 ml/naris), eye (0.02 ml/eye), and throat (0.2 ml) with Mycoplasma gallisepticum (MG) R strain (3.175 x 10(7) colony-forming units/ml). Fifty birds were treated with sterile broth and served as the controls; 25 of those were exposed to an inhalant, and the others were not treated. Infected birds were divided into four groups; 1) no treatment, 2) penicillin in drinking water, 3) inhalant, 4) both penicillin and inhalant. At days 3, 7, 10, 14, and 21 postinfection (PI), birds were assessed for clinical signs of disease. Five birds in each group were euthanatized at each interval PI; quantitative cultures were performed on lavages from the nares and trachea and on throat swabs; tracheas and air sacs were examined histopathologically. No clinical signs, lesions, or cultural isolations occurred in any control birds. All infected birds developed clinical signs and lesions of the trachea and air sac, but none died. The most severe clinical signs were seen in birds that were infected with MG and received no other intervention or birds that received penicillin in conjunction with infection. Increased respiratory tract lesions were associated with penicillin treatment; aerosol therapy resulted in fewer lesions.

Administration, Inhalation↗
PubMed2005

[Modern inhalation therapy].

Treatment with aerosols is the major form of treatment of obstructive airway disease. It has become possible not only as a result of improved medication, but also, and in particular, the continuing technological development of inhalation systems. The large selection of widely differing systems increases the chance of achieving effective treatment through appropriate individual application and good compliance. Even modern inhalation systems are not ideal in every respect and for every patient and disease stage. Only when correctly applied are almost all currently available systems clinically effective. When deciding what constitutes the best option, technological aspects of the systems together with the resulting demands made on the patient, as well as the mental and manual abilities and ventilatory characteristics of the patient, must be taken into account.

Adult↗
PubMed1994

[Inhalation therapy with nitric oxide--an evaluation of a dosage system and clinical examples].

In 1987 it was discovered that nitric oxide is a very potent vasodilator and in fact a natural mediator for vasodilatation. The effects of inhalation of nitric oxide on pulmonary vascular resistance were described in 1988 and a new therapeutic possibility for artificially ventilated patients with pulmonary hypertension has arisen. However, the administration of nitric oxide has to be performed with high accuracy and without reaching toxic levels of nitrogendioxide. We have evaluated a system using conventional air and oxygen rotameters for administration of nitric oxide via a ventilator. A comparison of the chemiluminescence technique with a technique based on fuel cells was also performed. With the system it was possible to administer nitric oxide with high accuracy within the range of 10-60 ppm without exceeding values for nitrogendioxide above 0.4 ppm. The analysis of nitric oxide and nitrogendioxide based on electrochemical cells proved to be comparable with the chemiluminescence technique within the same range. Nitric oxide inhalation was used in six patients with severe hypoxia and seemed to have a favorable effect on most of the patients.

Administration, Inhalation↗
PubMed1994

[Update on inhalation therapy in asthma and obstructive bronchopulmonary diseases].

Significant changes have occurred in aerosol therapy in the last few years. New devices have been developed to facilitate the administration of bronchodilator or anti-inflammatory drugs into the airways. Metered-dose inhaler with or without a spacer or powder devices are now considered the ideal mode of administration of aerosolized medications in the regular treatment of child or adult asthma as well as in COPD. In mild to moderate acute asthma, bronchodilators are ideally administered with a metered dose inhaler with a spacer device, nebulisation being required in only a minority of patients. Powder devices such as the Turbuhaler may also be useful in acute asthma but inspiratory flow should be sufficient, and their usefulness in this context remains to be better determined. In severe acute asthma or in patients unable to properly use the other inhalation devices, nebulisation can be used, with oxygen in the case of acute asthma. In patients requiring mechanical ventilation, administration of bronchodilators can be done with a metered-dose inhaler with a spacer device specifically designed for this purpose: it will replace nebulisation in most cases. In young children and infants unable to use spacer devices with a mouthpiece (< 5 years), wet nebulisation is still used during acute attacks of asthma. In these circumstances, the use of metered-dose inhalers with a spacer and mask are probably appropriate in some children but further studies are required to recommend their use.

Adult↗
PubMed2003

Inhaled therapy for acute adult asthma.

PURPOSE OF REVIEW: To evaluate recent developments on emergency department inhalotherapy in non-intubated acute adult asthma patients. RECENT FINDINGS: There is evidence that high-flow oxygen can be associated with hypercarbia, and that full humidification of the inspired gases should be recommended. On the contrary, there is a lack of evidence to support the role of heliox in the initial treatment of acute asthma. Specific short-acting inhaled beta(2)-agonists are the drugs of choice. A more rapid and profound bronchodilatation with fewer side effects and less time of treatment can be achieved when sufficient doses are given using pressurized meter dose inhalers and large-volume valved-spacers, particularly in patients with the most severe obstruction. Findings argue against the routine use of continuous nebulization. High and repetitive doses of ipratropium bromide in combination with beta(2)-agonists are indicated as first line treatment of severe acute asthma. There is insufficient evidence that inhaled corticosteroids alone are as effective as systemic corticosteroids. Finally, the combination of nebulized magnesium and albuterol provides no benefit in addition to that provided by therapy with albuterol in patients with mild-to-moderate asthma exacerbations. SUMMARY: According to the latest evidence, the goals of treatment may be summarized as follows: maintenance of adequate arterial oxygen saturation with supplemental oxygen, relief of airflow obstruction by administration of inhaled beta-agonists and anticholinergics, and reduction of airway inflammation and prevention of future relapses by using early administration of systemic corticosteroids.

Acute Disease↗