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Aerosol therapy

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https://www.readbyqxmd.com/read/28925894/aerosol-a-novel-vehicle-in-pharmacotherapy-in-neonates
#1
Ronan MacLoughlin, Colin Telfer, Andy Clark, James Fink
BACKGROUND: Local delivery of drugs to the lungs of newborn infant represents an unmet need as no drugs have been approved. Potential benefits could be large. Development of aerosol for delivery of drugs to infants and newborn offers huge potential for better therapy. Newborn infants present unique challenges with regard to aerosol therapy. Efficient deposition of aerosolized medications on the neonate airway surface is hampered by anatomical features such as small airway geometries and physiological features such as exquisitely small tidal volumes, rapid breathing and unfavorable inhalation:exhalation ratios...
September 18, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28919143/long-term-safety-of-glycopyrrolate-eflow-%C3%A2-cs-in-moderate-to-very-severe-copd-results-from-the-glycopyrrolate-for-obstructive-lung-disease-via-electronic-nebulizer-golden-5-randomized-study
#2
Gary T Ferguson, Thomas Goodin, Robert Tosiello, Alistair Wheeler, Edward Kerwin
BACKGROUND: The use of long-acting bronchodilators is an essential component of the management of chronic obstructive pulmonary disease (COPD). The GOLDEN 5 Phase III, randomized, active-controlled, open-label study was conducted to evaluate the long-term safety and tolerability of a nebulized glycopyrrolate formulation (SUN-101) delivered via the investigational eFlow(®) Closed System (eFlow(®) CS) nebulizer in subjects with moderate-to-very-severe COPD. METHODS: Subjects were randomized in a 4:3 ratio to nebulized glycopyrrolate 50 μg twice daily (BID) or tiotropium 18 μg once daily (OD) and treated for 48 weeks...
August 24, 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28900843/pressurized-intraperitoneal-aerosol-chemotherapy-pipac-procedure-for-non-resectable-peritoneal-carcinomatosis-with-video
#3
Jean-Baptiste Cazauran, Mohammad Alyami, Antoinette Lasseur, Isabo Gybels, Olivier Glehen, Naoual Bakrin
BACKGROUND: Peritoneal carcinomatosis (PC) is a common evolution of abdominal cancers and is associated with poor prognosis in the absence of aggressive multimodal therapy.1 Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a safe and innovative approach, which enhances the effect of chemotherapy 2 without reported renal/hepatic toxicity.3,4 It requires mastery of technical aspects to reduce postoperative morbidity, increase effectiveness, and prevent caregiver chemotherapy exposure...
September 12, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28898546/taking-the-challenge-a-protocolized-approach-to-optimize-pneumocystis-pneumonia-prophylaxis-in-renal-transplant-recipients
#4
K F Urbancic, F Ierino, E Phillips, P F Mount, A Mahony, J A Trubiano
While trimethoprim-sulfamethoxazole is considered first-line therapy for Pneumocystis pneumonia prevention in renal transplant recipients, reported adverse drug reactions may limit use and increase reliance on costly and less effective alternatives, often aerosolized pentamidine. We report our experience implementing a protocolized approach to trimethoprim-sulfamethoxazole adverse drug reaction assessment and rechallenge to optimize prophylaxis in this patient cohort. We retrospectively reviewed 119 patients receiving Pneumocystis pneumonia prophylaxis prior to and after protocol implementation...
September 12, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28874611/how-should-aerosols-be-delivered-during-invasive-mechanical-ventilation
#5
Rajiv Dhand
The delivery of aerosols to mechanically ventilated patients presents unique challenges and differs from inhaled drug delivery in spontaneously breathing patients in several respects. Successful aerosol delivery during invasive mechanical ventilation requires careful consideration of a host of factors that influence the amount of drug inhaled by the patient. Pressurized metered-dose inhalers and nebulizers (jet, ultrasonic, and vibrating mesh) are the most commonly used aerosol delivery devices in these patients, although other delivery devices, such as dry powder inhalers, soft mist inhalers, and intratracheal nebulizing catheters, could also be adapted for in-line use...
September 5, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28872662/current-options-in-aerosolised-drug-therapy-for-children-receiving-respiratory-support
#6
REVIEW
S Trend, B S von Ungern-Sternberg, S G Devadason, A Schultz, M L Everard
Inhalation of aerosolised medications are the mainstay of treatment for a number of chronic lung diseases and have several advantages over systemically-administered medications. These include more rapid onset of action for drugs such as β-adrenergic agonists when compared with oral medication, high luminal doses for inhaled antibiotics when used to treat endobronchial infection, and an improved therapeutic index compared with systemic delivery for these and other classes of drugs such as corticosteroids. The use of aerosolised drugs to treat patients whose tracheas are intubated is less well established, in part because systemic delivery via the intravenous route can be a simpler alternative for many drugs...
September 5, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28828368/inhalation-therapies-in-acute-respiratory-distress-syndrome
#7
REVIEW
Antonio Artigas, Marta Camprubí-Rimblas, Neus Tantinyà, Josep Bringué, Raquel Guillamat-Prats, Michael A Matthay
The defining features of acute respiratory distress syndrome (ARDS) are an excessive inflammatory respiratory response associated with high morbidity and mortality. Treatment consists mainly of measures to avoid worsening lung injury and cannot reverse the underlying pathophysiological process. New pharmacological agents have shown promising results in preclinical studies; however, they have not been successfully translated to patients with ARDS. The lack of effective therapeutic interventions has resulted in a recent interest in strategies to prevent ARDS with treatments delivering medications directly to the lungs by inhalation and nebulization, hopefully minimizing systemic adverse events...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28814858/spotlight-on-glycopyrronium-formoterol-fumarate-inhalation-aerosol-in-the-management-of-copd-design-development-and-place-in-therapy
#8
REVIEW
Santosh Dhungana, Gerard J Criner
Long-acting bronchodilators are the mainstay of the treatment of COPD. With the advent of several combination inhalers with long-acting antimuscarinic agents (LAMAs) and long-acting beta agonists (LABAs), the choice of therapy in the treatment of COPD has been ever expanding. With the focus of COPD management shifting from FEV1-based treatment escalation to symptoms and risk-based treatment, we are seeing a paradigm shift in COPD treatment with early introduction of LAMA-LABA combination as a single inhaler...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28810628/use-of-aerosol-inhalation-treatment-with-budesonide-and-terbutaline-sulfate-on-acute-pediatric-asthmatic-bronchitis
#9
Fangfang Bian, Yue-E Wu, Chong-Lin Zhang
The use of oxygen-driven aerosol inhalation therapy with budesonide (suspension) and terbutaline sulfate for the treatment of pediatric asthmatic bronchitis was studied. Sixty pediatric patients diagnosed with asthmatic bronchitis in Xuzhou Children's Hospital during the period comprising April 2013 to December 2015 were enrolled in the study. After randomly dividing the patients into a control (conventional dexamethasone drip) and a treatment group (inhalation of budesonide with terbutaline sulfate) of 30 patients each, the symptoms were treated using antibiotics when necessary...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28808506/the-knowledge-concerns-and-healthcare-practices-among-physicians-regarding-electronic-cigarettes
#10
Venkatkiran Kanchustambham, Swetha Saladi, Jonathan Rodrigues, Hermina Fernandes, Setu Patolia, Sadhashiv Santosh
Background: Electronic cigarettes (e-cigarettes) are battery-powered devices that deliver aerosolized nicotine. With easy access and over-the-counter availability, many patients consider using electronic cigarettes for smoking cessation. Few studies have looked at long-term safety/efficacy and physician knowledge/attitudes toward e-cigarettes. Physicians have insufficient guidelines for advising their patients about e-cigarettes. Objective: 1) To identify knowledge and attitude of health care practitioners toward electronic cigarettes...
July 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28779834/inhaled-antibiotics-for-ventilator-associated-infections
#11
REVIEW
Lucy B Palmer
Multidrug-resistant organisms are creating a challenge for physicians treating the critically ill. As new antibiotics lag behind the emergence of worsening resistance, intensivists in countries with high rates of extensively drug-resistant bacteria are turning to inhaled antibiotics as adjunctive therapy. These drugs can provide high concentrations of drug in the lung that could not be achieved with intravenous antibiotics without significant systemic toxicity. This article summarizes current evidence describing the use of inhaled antibiotics for the treatment of bacterial ventilator-associated pneumonia and ventilator-associated tracheobronchitis...
September 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28747346/modulation-of-roquin-function-in-myeloid-cells-reduces-mycobacterium-tuberculosis-induced-inflammation
#12
Gayathri Nagalingam, Carola G Vinuesa, Warwick J Britton, Bernadette M Saunders
Damaging inflammation is a hallmark of Mycobacterium tuberculosis infection, and understanding how this is regulated is important for the development of new therapies to limit excessive inflammation. The E3 ubiquitin ligase, Roquin, is involved in immune regulation; however, its role in immunity to M. tuberculosis is unknown. To address this, we infected mice with a point mutation in Roquin1/Rc3h1 (sanroque). Aerosol-infected sanroque mice showed enhanced control of M. tuberculosis infection associated with delayed bacterial dissemination and upregulated TNF production in the lungs after 2 wk...
September 1, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28737431/the-analysis-of-pneumatic-atomization-of-newtonian-and-non-newtonian-fluids-for-different-medical-nebulizers
#13
Marek Ochowiak, Magdalena Matuszak, Sylwia Włodarczak
OBJECTIVE: The paper contains results of the experimental studies on atomization process of inhaled drugs and aqueous solutions of glycerol with aqueous solutions of glycerol-polyacrylamide (Rokrysol WF1) in pneumatic nebulizers. In experiments the different concentration of aqueous solutions of glycerol-polyacrylamide have been tested. In addition, the effect of nebulizer design on atomization process has been determined. The one of the main elements of medical pneumatic nebulizer is nebulizer cup...
July 24, 2017: Drug Development and Industrial Pharmacy
https://www.readbyqxmd.com/read/28735415/cfd-simulation-of-aerosol-delivery-to-a-human-lung-via-surface-acoustic-wave-nebulization
#14
Morteza Yousefi, Oveis Pourmehran, Mofid Gorji-Bandpy, Kiao Inthavong, Leslie Yeo, Jiyuan Tu
Administration of drug in the form of particles through inhalation is generally preferable in the treatment of respiratory disorders. Conventional inhalation therapy devices such as inhalers and nebulizers, nevertheless, suffer from low delivery efficiencies, wherein only a small fraction of the inhaled drug reaches the lower respiratory tract. This is primarily because these devices are not able to produce a sufficiently fine drug mist that has aerodynamic diameters on the order of a few microns. This study employs computational fluid dynamics to investigate the transport and deposition of the drug particles produced by a new aerosolization technique driven by surface acoustic waves (SAWs) into an in silico lung model geometrically reconstructed using computed tomography scanning...
July 22, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28729731/anti-asthmatic-effect-of-pitavastatin-through-aerosol-inhalation-is-associated-with-cd4-cd25-foxp3-t-cells-in-an-asthma-mouse-model
#15
Songquan Wu, Ruhui Yang, Guangli Wang
Statins are competitive inhibitors of 3-hydroxy-3-methylglutaryl-CoA (HMG-A) reductase, and studies have shown that statins also have anti-inflammatory and immunomodulatory properties. The purpose of this study was to investigate the anti-asthmatic effects of pitavastatin, a type of statin, in an asthma mouse model. Mice were sensitized and challenged with ovalbumin (OVA) to establish the asthma model. These mice were then treated with inhaled pitavastatin (5 mg/kg) or dexamethasone (2 mg/kg), the latter of which served as a positive control...
July 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28708440/model-calculations-of-regional-deposition-and-disposition-for-single-doses-of-inhaled-liposomal-and-dry-powder-ciprofloxacin
#16
Andrew R Martin, Warren H Finlay
BACKGROUND: Model predictions of regional deposition in the respiratory tract are useful in assessing factors that influence the effectiveness of aerosol delivery. Regional deposition models have previously been coupled with models of mucous production and clearance to estimate initial concentrations of drug deposited in the airway surface liquid (ASL) lining tracheobronchial airways. METHODS: Established models of regional deposition and ASL volumes were used to provide input to a new model evaluating the disposition of drug resulting from dissolution or release, absorption, and mucociliary clearance...
July 14, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28701014/-spacer-aerosol-therapy-through-space-and-time
#17
Thomas Voshaar, Peter Haidl, Rolf Michael Clös
Aim of the literature review Within this review, results of a literature analysis on the application of spacers with pressurized metered dose inhalers (pMDI) are described and evaluated. Methods Next to an extensive revision on effects of spacers, the impacts of current guidelines and the conditions for product authorisations on the use of spacers are described which result from the interplay of characteristics from dose inhalers with a spacer. Results Spacers are generally useful to avoid coordination problems concerning the actuation of a pMDI at the beginning of an inhalation...
July 2017: Pneumologie
https://www.readbyqxmd.com/read/28692913/particle-and-bioaerosol-characteristics-in-a-paediatric-intensive-care-unit
#18
Congrong He, Ian M Mackay, Kay Ramsay, Zhen Liang, Timothy Kidd, Luke D Knibbs, Graham Johnson, Donna McNeale, Rebecca Stockwell, Mark G Coulthard, Debbie A Long, Tara J Williams, Caroline Duchaine, Natalie Smith, Claire Wainwright, Lidia Morawska
The paediatric intensive care unit (PICU) provides care to critically ill neonates, infants and children. These patients are vulnerable and susceptible to the environment surrounding them, yet there is little information available on indoor air quality and factors affecting it within a PICU. To address this gap in knowledge we conducted continuous indoor and outdoor airborne particle concentration measurements over a two-week period at the Royal Children's Hospital PICU in Brisbane, Australia, and we also collected 82 bioaerosol samples to test for the presence of bacterial and viral pathogens...
July 7, 2017: Environment International
https://www.readbyqxmd.com/read/28683218/biokinetics-of-aerosolized-liposomal-ciclosporin-a-in-human-lung-cells-in-vitro-using-an-air-liquid-cell-interface-exposure-system
#19
Otmar Schmid, Corinne Jud, Yuki Umehara, Dominik Mueller, Albert Bucholski, Friedrich Gruber, Oliver Denk, Roman Egle, Alke Petri-Fink, Barbara Rothen-Rutishauser
BACKGROUND: Inhalation of aerosolized drugs is a promising route for noninvasive targeted drug delivery to the lung. Nanocarrier systems such as liposomes have been explored for inhalation therapy opening new avenues, including stabilization of nonsoluble drugs (e.g., Ciclosporin A [CsA]) and controlled release. METHODS: The biokinetic behavior of the immunosuppressive drug CsA encapsulated in liposomes (L-CsA) at the lung epithelial barrier was studied in vitro...
July 6, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28662986/therapy-options-for-chronic-lung-allograft-dysfunction-bronchiolitis-obliterans-syndrome-following-first-line-immunosuppressive-strategies-a-systematic-review
#20
Christian Benden, Maria Haughton, Saoirse Leonard, Lars C Huber
BACKGROUND: Long-term success of lung transplantation is limited by the development of chronic lung allograft dysfunction (CLAD), of which bronchiolitis obliterans syndrome (BOS) is the most common form. This systematic review sought to identify the current evidence base for CLAD-BOS therapies after initial immunosuppressive treatment strategies. METHODS: The MEDLINE, Embase, and Cochrane Library databases from inception to May 3, 2016, were searched using keywords relating to CLAD-BOS, study designs, and treatments of interest, including extracorporeal photopheresis (ECP), aerosolized cyclosporine, total lymphoid irradiation (TLI), alemtuzumab, and montelukast...
September 2017: Journal of Heart and Lung Transplantation
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