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https://www.readbyqxmd.com/read/28933971/the-pharmacokinetics-safety-and-tolerability-of-single-high-strength-doses-of-fluticasone-propionate-and-fluticasone-propionate-salmeterol-delivered-via-a-novel-multidose-dry-powder-inhaler-in-adolescents-and-adults-with-persistent-asthma
#1
Courtney Nugent, Gloria Yiu, Sharon Song, Cynthia Caracta
OBJECTIVE: Characterize fluticasone propionate (Fp) and combination fluticasone propionate and salmeterol (FS) pharmacokinetic and safety profiles, delivered via a novel, inhalation-driven, multidose dry powder inhaler (MDPI). METHODS: This multicenter, open-label, 4-period crossover, single-dose study randomized patients aged ≥12 years with persistent asthma to Fp MDPI 200 mcg, FS MDPI 200/12.5 mcg, Fp dry powder inhaler (DPI) 500 mcg (250 mcg × 2 inhalations), or FS DPI 500/50 mcg...
September 21, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28933581/peak-inspiratory-flow-rate-in-chronic-obstructive-pulmonary-disease-implications-for-dry-powder-inhalers
#2
Sohini Ghosh, Jill A Ohar, M Bradley Drummond
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States with a significant economic burden related to hospital admissions for exacerbations. One of the primary treatment modalities for COPD is medications delivered through breath-actuated dry powdered inhalers (DPIs). For users to successfully receive inhaled medication, they must inhale with enough flow to overcome the internal resistance of the device, leading to deaggregation of the medication powder. Peak inspiratory flow rate (PIFR) is the maximal flow rate obtained during an inspiratory maneuver...
September 21, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28929816/which-inhaled-corticosteroid-and-long-acting-%C3%AE-agonist-combination-is-better-in-patients-with-moderate-to-severe-asthma-a-dry-powder-inhaler-or-a-pressurized-metered-dose-inhaler
#3
Masato Muraki, Kyuya Gose, Soichiro Hanada, Hirochiyo Sawaguchi, Yuji Tohda
Two main types of devices are used to facilitate the administration of inhaled corticosteroid (ICS) and long-acting β-agonist (LABA) in combination, dry powder inhalers (DPIs) and pressurized metered-dose inhalers (pMDIs). There are few reports comparing the effects of the two devices, and it is unknown which should be recommended for asthma patients with given sets of characteristics. In the current study, the beneficial effects and side effects associated with DPIs and pMDIs were compared, and the question of which device should be recommended for asthma patients was investigated...
November 2017: Drug Delivery
https://www.readbyqxmd.com/read/28927489/role-of-exhaled-nasal-nitric-oxide-in-distinguishing-between-chronic-rhinosinusitis-with-and-without-nasal-polyps
#4
(no author information available yet)
BACKGROUND: Chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP) nasal polypsis a global health concern. Several clinical biomarkers, such as inhaled carbon monoxide and exhaled nitric oxide (NO), have been studied to assess the presence and degree of inflammation in the airway mucosa. OBJECTIVE: To evaluate the clinical application of exhaled nasal NO (nNO) in distinguishing between CRSwNP and CRSsNP in consideration of the atopic status of patients...
September 19, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28926855/a-comparison-of-the-efficacy-of-once-daily-fluticasone-furoate-vilanterole-with-twice-daily-fluticasone-propionate-salmeterol-in-elderly-asthmatics
#5
Yoshihisa Ishiura, Masaki Fujimura, Yasutaka Shiba, Noriyuki Ohkura, Johsuke Hara, Miki Abo, Kazuo Kasahara
Background Asthma in the elderly population has been focused because it affects quality of life and results in a higher hospitalization rate and mortality. Fluticasone furoate (FF)/vilanterole (VI) is a novel inhaled corticosteroids (ICS)/long-acting β2 agonist (LABA) combination being developed for once-daily administration for asthma with greater anti-inflammatory activity and longer duration of bronchidilation. The Ellipta(TM) dry powder inhaler (DPI) has also been available as a new device with high levels of satisfaction and preference...
September 19, 2017: Drug Research
https://www.readbyqxmd.com/read/28918665/considerations-in-establishing-bioequivalence-of-inhaled-compounds
#6
Irvin Mayers, Mohit Bhutani
Generic inhalers are often perceived as inferior to their branded counterparts; however, they are safe and effective if they can meet the regulatory requirements. The approach to assess bioequivalence (BE) in oral dosage form products is not sufficient to address the complexities of inhalational products (e.g., patient-device interface); hence, more considerations are needed and caution should be applied in determining BE of inhaled compounds. Areas covered: This review outlines the evaluation process for generic inhalers, explores the regulatory approaches in BE assessment, and highlights the considerations and challenges in the current in vitro and in vivo approaches (lung deposition, pharmacokinetic, pharmacodynamic/clinical studies, and patient-device interface) for establishing BE of inhaled compounds...
September 18, 2017: Expert Opinion on Drug Delivery
https://www.readbyqxmd.com/read/28894051/standardization-of-the-collection-of-exhaled-breath-condensate-and-exhaled-breath-aerosol-using-a-feedback-regulated-sampling-device
#7
Brett R Winters, Joachim D Pleil, Michelle M Angrish, Matthew A Stiegel, Terence H Risby, Michael C Madden
Exhaled breath condensate (EBC) and associated exhaled breath aerosols (EBA) are valuable non-invasive biological media used for the quantification of biomarkers. EBC contains exhaled water vapor, soluble gas-phase (polar) organic compounds, ionic species, plus other species including semi- and non-volatile organic compounds, proteins, cell fragments, DNA, dissolved inorganic compounds, ions, and micro-biota (bacteria and viruses) dissolved in the co-collected EBA. EBC is collected from subjects who breathe "normally" through a chilled tube assembly for approximately 10 minutes and is then harvested into small vials for analysis...
September 12, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28891722/requirements-strengths-and-weaknesses-of-inhaler-devices-for-copd-patients-from-the-expert-prescribers-point-of-view-results-of-the-epoca-delphi-consensus
#8
Francisco García-Río, Juan J Soler-Cataluña, Bernardino Alcazar, José L Viejo, Marc Miravitlles
The study aimed to assess the preferences of expert physicians about the requirements for inhalation devices for patients with chronic obstructive pulmonary disease (COPD) and to identify the most relevant advantages and disadvantages to their prescription. In a two-round Delphi survey, 96 Spanish COPD-expert pulmonologists completed an internet-based questionnaire to evaluate the degree of importance of the characteristics of the inhaler devices in their choice for COPD. The requirements needed for use in COPD were that the device permits a high pulmonary deposit of the drug, allowed its dispensation at low inspiratory flows, did not require hand-mouth coordination, generated an exact and reproducible dose, its operation was easy to teach, provided the perception of a correct inhalation, had an intuitive use mechanism and security mechanisms to prevent overdosing and generates a reduced oropharyngeal deposit (very good consensus)...
September 11, 2017: COPD
https://www.readbyqxmd.com/read/28887061/advances-in-audio-based-systems-to-monitor-patient-adherence-and-inhaler-drug-delivery
#9
REVIEW
Terence E Taylor, Yaniv Zigel, Céline De Looze, Imran Sulaiman, Richard W Costello, Richard B Reilly
Hundreds of millions of people suffer from asthma and chronic obstructive pulmonary disease (COPD) worldwide. Current medications to control these chronic respiratory diseases can be administered using inhaler devices, such as the pressurized metered dose inhaler (pMDI) and dry powder inhaler (DPI). Providing that they are used as prescribed, inhalers can improve patients' clinical outcomes and quality of life. Poor patient inhaler adherence (both time of use and user technique) is, however, a major clinical concern and is associated with poor disease control, increased hospital admissions and increased mortality rates, particularly in low-middle income countries...
September 5, 2017: Chest
https://www.readbyqxmd.com/read/28886758/evaluation-of-beclomethasone-dipropionate-80-and-160-micrograms-day-delivered-via-a-breath-actuated-inhaler-for-persistent-asthma
#10
(no author information available yet)
BACKGROUND: Breath-actuated inhalers (BAI) may simplify the delivery of inhaled medications compared with other devices. OBJECTIVE: To evaluate the efficacy and safety of beclomethasone dipropionate BAI versus matching placebo in adolescent and adult patients with persistent asthma. METHODS: This phase III, 12-week, double-blind study enrolled patients with asthma aged greater than or equal to 12 years who were previously treated with a stable dose of inhaled corticosteroid or noncorticosteroid therapy...
September 8, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/28882385/lung-deposition-and-systemic-bioavailability-of-different-aerosol-devices-with-and-without-humidification-in-mechanically-ventilated-patients
#11
Islam O F Moustafa, Mohammed R A-A Ali, Moataz Al Hallag, Hoda Rabea, James B Fink, Patricia Dailey, Mohamed E A Abdelrahim
BACKGROUND: During mechanical ventilation medical aerosol delivery has been reported to be upto two fold greater with dry inhaled gas than with heated humidity. Urine levels at 0.5 h post dose (URSAL0.5%) has been confirmed as an index of lung deposition and 24 h (URSAL24%) as index of systemic absorption. Our aim was to determine the effect of humidification and aerosol device type on drug delivery to ventilated patients using urine levels. METHODS: In a randomized crossover design, 36 (18female) mechanically ventilated patients were assigned to one of three groups...
September 4, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28874611/how-should-aerosols-be-delivered-during-invasive-mechanical-ventilation
#12
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
#13
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/28872037/executive-dysfunctions-as-a-good-predictor-of-misuse-of-respiratory-inhalers-among-hospitalized-patients-a-prospective-survey
#14
Lucie Voulhoux, Gérald Cremer, Anne Spinewine, Marie de Saint-Hubert, Fabienne Amant, Carine Sohy, Didier Schoevaerdts
The objectives of the study are to determine the prevalence and potential risk factors of misuse of respiratory inhalers among hospitalized patients admitted at the CHU UcL Namur, site Godinne. Using a cross-sectional design, patients using respiratory inhalers since more than 7 days were recruited from a database established by the hospital pharmacy. Inhaler technique was assessed using a standardised check-list and graded misuse as major or minor errors using previously published criteria. Demographic and clinical data were prospectively collected using standardised tools...
September 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28871584/selected-aspects-of-medical-care-for-patients-with-asthma-and-chronic-obstructive-pulmonary-disease-copd-in-poland
#15
Joanna Miłkowska-Dymanowska, Adam J Białas, Paweł Górski
INTRODUCTION: Noncompliance with healthcare undoubtedly has a strong influence on the high prevalence of uncontrolled obstructive diseases. The aim of our study was to evaluate the quality of medical conduct in patients with asthma or chronic obstructive lung diseases (COPD), with encompassed two-levelled system of health care. MATERIAL AND METHODS: A survey of general practitioners (GP), allergists and pulmonologists practicing in Poland was performed between September and December 2016...
2017: Advances in Respiratory Medicine
https://www.readbyqxmd.com/read/28868931/emerging-inhaled-long-acting-beta-2-adrenoceptor-agonists-for-the-treatment-of-copd
#16
REVIEW
Thomas J Monaco, Nicola A Hanania
Chronic obstructive pulmonary disease (COPD), characterized by persistent and partially reversible airflow obstruction, is a leading cause of morbidity and mortality worldwide. Long-acting inhaled bronchodilators form the backbone for the maintenance therapy for this disease. The ultra-long-acting β2-agonists (ultra-LABAs) represent novel pharmacologic agents with interesting potential benefits as stand-alone therapy or in combination with other therapies for the treatment of COPD. Areas covered: In this review, we will focus newly developed ultra-LABAs, describing currently available evidence of their clinical effect and safety, their comparison relative to older long-acting β2-agonists, and their potential niche in the maintenance treatment of COPD...
September 2017: Expert Opinion on Emerging Drugs
https://www.readbyqxmd.com/read/28865687/electrohydrodynamic-methods-for-the-development-of-pulmonary-drug-delivery-systems
#17
Maria Nikolaou, Theodora Krasia-Christoforou
Electrospinning and electrospraying are two highly versatile and scalable electrohydrodynamic methods, which have attracted considerable attention during the last years towards the fabrication of polymer-based drug delivery systems. The latter may be obtained in the form of nano- or microfibers (via electrospinning) or as drug-loaded nano- and microparticles (via electrospraying). This review article begins with an introduction on the basic principles and the important influencing parameters governing the electrospinning/electrospraying processes, followed by an overview on their use for the development of nano/microfibers and nano/microparticles destined for use in pharmaceutical applications...
August 30, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28864391/particle-interactions-of-fluticasone-propionate-and-salmeterol-xinafoate-detected-with-single-particle-aerosol-mass-spectrometry-spams
#18
Martin W Jetzer, Bradley D Morrical, David P Fergenson, Georgios Imanidis
Particle co-associations between the active pharmaceutical ingredients fluticasone propionate and salmeterol xinafoate were examined in dry powder inhaled (DPI) and metered dose inhaled (MDI) combination products. Single Particle Aerosol Mass Spectrometry was used to investigate the particle interactions in Advair Diskus(®) (500/50 mcg) and Seretide(®) (125/25 mcg). A simple rules tree was used to identify each compound, either alone or co-associated at the level of the individual particle, using unique marker peaks in the mass spectra for the identification of each drug...
August 31, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28861655/inhaled-anesthetic-agent-sedation-in-the-icu-and-trace-gas-concentrations-a-review
#19
REVIEW
Jennifer Herzog-Niescery, Hans-Martin Seipp, Thomas Peter Weber, Martin Bellgardt
There is a growing interest in the use of volatile anesthetics for inhalational sedation of adult critically ill patients in the ICU. Its safety and efficacy has been demonstrated in various studies and technical equipment such as the anaesthetic conserving device (AnaConDa™; Sedana Medical, Uppsala, Sweden) or the MIRUS™ system (Pall Medical, Dreieich, Germany) have significantly simplified the application of volatile anesthetics in the ICU. However, the personnel's exposure to waste anesthetic gas during daily work is possibly disadvantageous, because there is still uncertainty about potential health risks...
August 31, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28858552/nitrous-oxide-inhalation-sedation-through-a-nasal-high-flow-system-the-possibility-of-a-new-technique-in-dental-sedation
#20
Takuro Sanuki, Gaku Mishima, Kensuke Kiriishi, Shinji Kurata, Ichiro Okaysu, Mari Kawai, Toshihiro Watanabe, Mizuki Tachi, Nobuyasu Komasawa, Takao Ayuse
High-flow nasal cannula (HFNC) systems are increasingly used for patients with both acute and chronic respiratory failure because of the clinical effectiveness and patient comfort associated with their use. Recently, HFNC has been used not only as a respiratory support device, but also as a drug delivery system. HFNC is designed to administer heated and humidified inspiratory oxygen flows (100% relative humidity at 37°C). Therefore, HFNC can provide high flows (up to 60 L/min) without discomfort. Moreover, HFNC improves oxygenation by exerting physiologic effects such as (a) dead-space washout and (b) moderate positive airway pressure...
2017: Anesthesia Progress
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