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Inhaled beta agonists

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https://www.readbyqxmd.com/read/28496190/beta-agonist-overuse-and-delay-in-obtaining-medical-review-in-high-risk-asthma-a-secondary-analysis-of-data-from-a-randomised-controlled-trial
#1
Janine Pilcher, Mitesh Patel, Alison Pritchard, Darmiga Thayabaran, Stefan Ebmeier, Dominick Shaw, Peter Black, Irene Braithwaite, Mark Weatherall, Richard Beasley
Asthma mortality surveys report delays in seeking medical review and overuse of beta-agonist therapy as factors contributing to a fatal outcome. However, the strength of these associations is limited because many asthma deaths are unwitnessed. We undertook a secondary analysis of data from a 24-week randomised controlled trial of 303 patients with high-risk asthma, randomised to combination budesonide/formoterol inhaler according to a single maintenance and reliever therapy regimen or fixed dose budesonide/formoterol with salbutamol as reliever (Standard) regimen...
May 11, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28484598/the-evidence-on-tiotropium-bromide-in-asthma-from-the-rationale-to-the-bedside
#2
REVIEW
Dejan Radovanovic, Pierachille Santus, Francesco Blasi, Marco Mantero
Severe and poorly controlled asthma still accounts for a great portion of the patients affected. Disease control and future risk management have been identified by international guidelines as the main goals in patients with asthma. The need for new treatment approaches has led to reconsider anticholinergic drugs as an option for asthma treatment. Tiotropium is the first anticholinergic drug that has been approved for children and adults with poorly controlled asthma and is currently considered as an option for steps 4 and 5 of the Global Initiative for Asthma...
2017: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/28410944/-asthma-control-in-patients-attending-primary-care-in-spain-actis-study
#3
Eduardo Calvo, Juan A Trigueros, Araceli López, Guadalupe Sánchez
OBJECTIVE: To assess prevalence of non controlled (ACT- Asthma Control Test<20) asthma in real world clinical practice in Spain. DESIGN: Observational, cross-sectional study. LOCATION: 58 primary care centers from 13 Autonomous Communities. PARTICIPANTS: Asthma patients attending physicians office to collect repeat prescriptions for continuous treatment (Group A), or due to symptoms worsening (Group B). MAIN MEASUREMENTS: Socio-demographic characteristics (age, gender, education, smoking history), physician's assessment of asthma severity, current treatment for asthma, co-morbidities, healthcare-related resources utilization (primary care or emergency visits, hospitalizations), labour or school absenteeism, ACT score and treatment adherence...
April 12, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28410560/role-of-long-acting-muscarinic-antagonist-long-acting-%C3%AE-2-agonist-therapy-in-chronic-obstructive-pulmonary-disease
#4
Sarah E Petite
OBJECTIVE: To compare the available literature regarding the use of long-acting muscarinic antagonist (LAMA)/long-acting β2 agonists (LABA) and inhaled corticosteroid (ICS)/LABA combination inhaler therapy in chronic obstructive pulmonary disease (COPD) maintenance therapy management. DATA SOURCES: A MEDLINE literature search from database inception to February 2017 was conducted using the search terms chronic obstructive pulmonary disease, adrenergic beta-agonist, muscarinic antagonist, and inhaled corticosteroid...
April 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28383836/-study-of-the-month-flame-study-in-chronic-obstructive-pulmonary-disease
#5
REVIEW
J-L Corhay
The place of combinations of bronchodilators (longacting beta-agonist / muscarinic agonist or LABA / LAMA) in the prevention of the exacerbations of the chronic obstructive pulmonary disease (COPD) is not still clearly established, and need a comparison with combination of LABA/ inhaled steroids. FLAME was a randomized non-inferiority phase 3 study comparing indacaterol/glycopyrronium 110/50 μg (IND/GLY) once daily with salmeterol/proprionate of fluticasone 50/500 μg (SAL/FC) twice daily. The primary objective of the study was to demonstrate that IND/GLY was non-inferior to SAL/FC in terms of reduction of all COPD exacerbations (mild/moderate/severe) during 52 weeks of treatment in patients having had at least 1 exacerbation in previous 12 months...
September 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28366158/-new-bronchodilators-and-combinations-in-copd-treatment
#6
Sibel Günay, Muzaffer Sarıaydın, Nilgün Yılmaz Demirci
Bronchodilator drugs are widely used therapeutic agents for treatment of asthma and chronic obstructive pulmonary disease (COPD). In order to mantain bronchodilation, both sympathetic system (particularly beta-2 receptors) activation and parasympathetic system inhibition (antimuscarinic effect) mechanisms are utilized. Over 20 years, there were no significant changes in bronchodilator therapy in obstructive pulmonary diseases. In recent years, however, after the development of new ultra long acting bronchodilator drugs, a single dose inhaler treatments per day in the treatment of stable COPD became a current issue...
September 2016: Tüberküloz Ve Toraks
https://www.readbyqxmd.com/read/28351789/comparative-effectiveness-of-step-up-therapies-in-children-with-asthma-prescribed-inhaled-corticosteroids-a-historical-cohort-study
#7
Clare S Murray, Mike Thomas, Kathryn Richardson, David B Price, Steve W Turner
BACKGROUND: In children with uncontrolled asthma prescribed low-dose inhaled corticosteroids (ICSs), various step-up options are available: fixed-dose combination ICS/long-acting β2-agonist (FDC), increasing ICS dose, or adding leukotriene receptor antagonist (LTRA). However, evidence of their relative effectiveness is limited. OBJECTIVE: To compare the effectiveness of step-up treatment to FDC in children with asthma versus increased ICS dose, or LTRA. METHODS: This matched cohort study used UK primary-care databases to study children prescribed their first step-up treatment to FDC, increased ICS dose, or LTRA...
March 25, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28334727/discovering-the-relative-efficacy-of-inhaled-medications-for-chronic-obstructive-pulmonary-disease-multiple-treatment-comparisons
#8
Ying Zhu, Tong Zhang, Haiyan Li, Yang Yang, Qiong Chen, Lei Kong, Bo Tai
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is managed by three major classes of inhaled medications: inhaled corticosteroids (ICS), long-acting Beta 2-agonist (LABA), long-acting muscarinic antagonist (LAMA). Single inhaled medication is usually replaced by combined inhaled medications for efficacy enhancement. However, this practice should be supported by clinical evidence for large-scale implementations. METHODS: The relative efficacy of inhaled medications is determined by three endpoints: changes in the trough forced expiratory volume in 1 second (tFEV1), changes in the St George's Respiratory Questionnaire (SGRQ) score and the proportion of SGRQ responders which represents a reduction in SGRQ total score at week 24 of ≥4...
2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28327480/pharmacotherapy-of-patients-with-stable-bronchial-asthma
#9
REVIEW
Ashutosh Nath Aggarwal
Several reliever and controller medications are available for managing patients with stable asthma. Inhaled corticosteroids (ICS) are the mainstay of treatment, and can be combined with long-acting beta-agonists (LABA) for patients with moderate or severe disease. An ICS-LABA combination is best administered as a single inhaler used for both maintenance and emergency use. A stepwise approach to therapy has recently been proposed as part of Indian guidelines for management of asthma. Clinicians should advise proper use of inhaled medications, and step up or step down treatment based on adequacy of asthma control...
November 2016: National Medical Journal of India
https://www.readbyqxmd.com/read/28325523/total-management-of-chronic-obstructive-pulmonary-disease-copd-as-an-independent-risk-factor-for-cardiovascular-disease
#10
REVIEW
Katsuya Onishi
Patients with cardiovascular disease (CVD) often have multiple comorbid conditions that may interact with each other, confound the choice of treatments, and reduce mortality. Chronic obstructive pulmonary disease (COPD) is one of the most important comorbidities of CVD, which causes serious consequences in patients with ischemic heart disease, stroke, arrhythmia, and heart failure. COPD shares common risk factors such as tobacco smoking and aging with CVD, is associated with less physical activity, and produces systemic inflammation and oxidative stress...
March 18, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28286157/inhaler-errors-in-the-critikal-study-type-frequency-and-association-with-asthma-outcomes
#11
David B Price, Miguel Román-Rodríguez, R Brett McQueen, Sinthia Bosnic-Anticevich, Victoria Carter, Kevin Gruffydd-Jones, John Haughney, Svein Henrichsen, Catherine Hutton, Antonio Infantino, Federico Lavorini, Lisa M Law, Karin Lisspers, Alberto Papi, Dermot Ryan, Björn Ställberg, Thys van der Molen, Henry Chrystyn
BACKGROUND: Poor inhaler technique has been linked to poor asthma outcomes. Training can reduce the number of inhaler errors, but it is unknown which errors have the greatest impact on asthma outcomes. OBJECTIVE: The CRITical Inhaler mistaKes and Asthma controL study investigated the association between specific inhaler errors and asthma outcomes. METHODS: This analysis used data from the iHARP asthma review service-a multicenter cross-sectional study of adults with asthma...
March 9, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28281043/preoperative-management-using-inhalation-therapy-for-pulmonary-complications-in-lung-cancer-patients-with-chronic-obstructive-pulmonary-disease
#12
Kyoshiro Takegahara, Jitsuo Usuda, Tatsuya Inoue, Takayuki Ibi, Akira Sato
OBJECTIVE: This study aimed to investigate whether perioperative inhalations of long-acting beta-agonists (LABAs) or long-acting muscarinic antagonists (LAMAs) might decrease the incidence of postoperative complications in lung cancer patients with chronic obstructive pulmonary disease (COPD). METHODS: We retrospectively analyzed 108 patients with COPD who underwent pulmonary resections for primary lung cancer at our hospital between January 2013 and January 2016 to determine the association between the incidence of postoperative complications (e...
March 9, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28255962/bringing-stability-to-the-chronic-obstructive-pulmonary-disease-patient-clinical-and-pharmacological-considerations-for-frequent-exacerbators
#13
REVIEW
Swati Gulati, J Michael Wells
Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are critical events associated with an accelerated loss of lung function, increased morbidity, and excess mortality. AECOPD are heterogeneous in nature and this may directly impact clinical decision making, specifically in patients with frequent exacerbations. A 'frequent exacerbator' is a sub-phenotype of chronic obstructive pulmonary disease (COPD) and is defined as an individual who experiences two or more moderate-to-severe exacerbations per year...
April 2017: Drugs
https://www.readbyqxmd.com/read/28240689/randomized-clinical-trial-of-a-combination-of-an-inhaled-corticosteroid-and-beta-agonist-in-patients-at-risk-of-developing-the-acute-respiratory-distress-syndrome
#14
RANDOMIZED CONTROLLED TRIAL
Emir Festic, Gordon E Carr, Rodrigo Cartin-Ceba, Richard F Hinds, Valerie Banner-Goodspeed, Vikas Bansal, Adijat T Asuni, Daniel Talmor, Govindarajan Rajagopalan, Ryan D Frank, Ognjen Gajic, Michael A Matthay, Joseph E Levitt
OBJECTIVES: Effective pharmacologic treatments directly targeting lung injury in patients with the acute respiratory distress syndrome are lacking. Early treatment with inhaled corticosteroids and beta agonists may reduce progression to acute respiratory distress syndrome by reducing lung inflammation and enhancing alveolar fluid clearance. DESIGN: Double-blind, randomized clinical trial (ClinicalTrials.gov: NCT01783821). The primary outcome was longitudinal change in oxygen saturation divided by the FIO2 (S/F) through day 5...
May 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28220767/asthma-control-in-adult-patients-treated-with-a-combination-of-inhaled-corticosteroids-and-long%C3%A2-acting-%C3%AE-2%C3%A2-agonists-a-prospective-observational-study
#15
Barbara Rogala, Paweł Majak, Joanna Glück, Tomasz Dębowski
INTRODUCTION    Asthma is a highly prevalent disease that often requires maintenance therapy. Combined inhaled corticosteroid (ICS) and long‑acting β2‑agonist (LABA) inhalers are one of the available maintenance treatment options. OBJECTIVES    This prospective observational study aimed to assess asthma control in patients treated with ICS/LABA inhalers and to identify factors related to optimal asthma control. PATIENTS AND METHODS    The study included 5789 asthmatic patients from Poland, treated with one of the following ICS/LABA inhalers at clinically appropriate doses: beclomethasone/formoterol, fluticasone/ salmeterol, or budesonide/formoterol...
January 18, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28203071/long-acting-bronchodilators-with-or-without-inhaled-corticosteroids-and-30-day-readmission-in-patients-hospitalized-for-copd
#16
Raju Bishwakarma, Wei Zhang, Yong-Fang Kuo, Gulshan Sharma
BACKGROUND: The ability of a long-acting muscarinic antagonist (LAMA) and long-acting beta 2 agonists (LABAs; long-acting bronchodilators, LABDs) with or without inhaled corticosteroids (ICSs) to reduce early readmission in hospitalized patients with COPD is unknown. METHODS: We studied a 5% sample of Medicare beneficiaries enrolled in Medicare parts A, B and D and hospitalized for COPD in 2011. We examined prescriptions filled for LABDs with or without ICSs (LABDs±ICSs) within 90 days prior to and 30 days after hospitalization...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28194189/day-time-variation-of-serum-periostin-in-asthmatic-adults-treated-with-ics-laba-and-adults-without-asthma
#17
Rachel Caswell-Smith, Terrianne Cripps, Thom Charles, Alexander Hosking, Meghana Handigol, Cecile Holweg, John Matthews, Mark Holliday, Corentin Maillot, James Fingleton, Mark Weatherall, Richard Beasley, Irene Braithwaite
BACKGROUND: We aimed to determine the effect of sampling time during the day on serum periostin levels in adult participants with and without asthma. METHODS: Serum periostin was measured at 2-h intervals from 0800 to 1800 h in 16 adult participants with stable asthma prescribed inhaled corticosteroid and long-acting beta-agonist therapy, and in 16 otherwise healthy participants without asthma. Mixed linear models were used to compare time zero (08:00 h) with subsequent measurement time for serum periostin for both groups...
2017: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/28185242/long-acting-muscarinic-antagonist-lama-plus-long-acting-beta-agonist-laba-versus-laba-plus-inhaled-corticosteroid-ics-for-stable-chronic-obstructive-pulmonary-disease-copd
#18
REVIEW
Nobuyuki Horita, Atsushi Goto, Yuji Shibata, Erika Ota, Kentaro Nakashima, Kenjiro Nagai, Takeshi Kaneko
BACKGROUND: Three classes of inhaler medications are used to manage chronic obstructive pulmonary disease (COPD): long-acting beta-agonists (LABA), long-acting muscarinic antagonists (LAMA), and inhaled corticosteroids (ICS). When two classes of medications are required, LAMA plus LABA (LAMA+LABA) and LABA plus ICS (LABA+ICS) are often selected because these combinations can be administered via a single medication device. The previous Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidance recommended LABA+ICS as the first-line treatment for managing stable COPD in high-risk people of categories C and D...
February 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28146601/stepping-down-the-dose-of-inhaled-corticosteroids-for-adults-with-asthma
#19
REVIEW
Iain Crossingham, David Jw Evans, Nathan R Halcovitch, Paul A Marsden
BACKGROUND: Asthma is a condition of the airways affecting more than 300 million adults and children worldwide. National and international guidelines recommend titrating up the dose of inhaled corticosteroids (ICS) to gain symptom control at the lowest possible dose because long-term use of higher doses of ICS carries a risk of systemic adverse events. For patients whose asthma symptoms are controlled on moderate or higher doses of ICS, it may be possible to reduce the dose of ICS without compromising symptom control...
February 1, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28144054/current-trends-of-management-of-respiratory-diseases-by-pulmonologists-results-of-national-conference-of-pulmonary-disease-2015-survey
#20
Sheetu Singh, Nishtha Singh
CONTEXT: Respiratory diseases are a common problem in our country and these are associated with significant morbidity and mortality. AIMS: The aim of the paper was to analyze the pattern of diagnostic tests used and treatment prescribed for common respiratory diseases. SETTINGS AND DESIGN: A total of 1028 pulmonologists, either member of Indian Chest Society or delegate attending the National Conference of Pulmonary Diseases (NAPCON) 2015, participated in the online survey...
January 2017: Lung India: Official Organ of Indian Chest Society
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