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Inhaled medications

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https://www.readbyqxmd.com/read/28427550/home-made-spacer-as-an-auxiliary-device-in-administration-of-beclomethasone-via-pressurized-metered-dose-inhaler-for-asthma-control-a-randomized-controlled-pragmatic-trial
#1
Deborah Schor, José Ângelo Rizzo, Decio Medeiros, Ana Carolina Dela Bianca, Almerinda Rego Silva, Carlos Nunes, Mário Morais-Almeida, Emanuel Sarinho
BACKGROUND: Holding chambers or spacers can enhance the efficacy of pressurized metered dose inhalers (pMDI) in delivering inhaled medications, as they reduce the need for hand-breath coordination and improve lower airways deposition. Nevertheless, their cost can be high for patients in low-income countries. OBJECTIVE: To compare asthma control achieved with beclomethasone-dipropionate administered through a hydrofluoroalkane-driven pMDI (BDp-pMDI) coupled to a home-made spacer (HmS) or to a valved commercial spacer (VCS) as auxiliary devices...
May 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28427541/long-term-safety-and-efficacy-of-glycopyrrolate-formoterol-metered-dose-inhaler-using-novel-co-suspension%C3%A2-delivery-technology-in-patients-with-chronic-obstructive-pulmonary-disease
#2
Nicola A Hanania, Donald P Tashkin, Edward M Kerwin, James F Donohue, Michael Denenberg, Denis E O'Donnell, Dean Quinn, Shahid Siddiqui, Chad Orevillo, Andrea Maes, Colin Reisner
BACKGROUND: The long-term safety and efficacy of a novel Co-Suspension™ Delivery Technology glycopyrrolate (GP)/formoterol fumarate (FF) 18/9.6 μg fixed-dose combination metered dose inhaler (GFF MDI) were investigated in a 28-week safety extension study (PINNACLE-3, NCT01970878) of two randomized controlled Phase III trials (PINNACLE-1 and -2; NCT01854645 and NCT01854658) in subjects with moderate-to-very severe chronic obstructive pulmonary disease (COPD). METHODS: Subjects completing 24 weeks' treatment with GFF MDI, GP MDI, FF MDI (all twice-daily) or open-label tiotropium 18 μg (once-daily) in PINNACLE-1 or -2 were randomly selected to continue treatment for 28 weeks...
May 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28422881/comparison-of-effects-of-desflurane-and-sevoflurane-on-postoperative-nausea-vomiting-and-pain-in-patients-receiving-opioid-based-intravenous-patient-controlled-analgesia-after-thyroidectomy-propensity-score-matching-analysis
#3
Il Jae Yoon, Hyun Kang, Chong Wha Baek, Geun Joo Choi, Yong-Hee Park, Yong Hun Jung, Young Cheol Woo, Sangseok Lee
In this study, we aimed to compare the effect of desflurane and sevoflurane on postoperative nausea and vomiting and pain in patients receiving opioid-based intravenous patient-controlled analgesia (IV-PCA) after thyroidectomy.We reviewed the electronic medical records of 1042 patients administered opioid-based IV-PCA after a thyroidectomy at Chung-Ang University Hospital between January 1, 2010 and June 30, 2016. We classified the patients into 2 groups according to the inhalation anesthetic used for anesthesia: desflurane versus sevoflurane (groups D and S, n = 587 and 455, respectively)...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28421191/prospective-multicentre-study-on-the-epidemiology-and-current-therapeutic-management-of-severe-bronchiolitis-in-spain
#4
Jose C Flores-González, Juan Mayordomo-Colunga, Iolanda Jordan, Alicia Miras-Veiga, Cristina Montero-Valladares, Marta Olmedilla-Jodar, Andrés J Alcaraz-Romero, Miren Eizmendi-Bereciartua, Francisco Fernández-Carrión, Carmen Santiago-Gutierrez, Esther Aleo-Luján, Sonia Pérez-Quesada, Cristina Yun-Castilla, Carmen Martín, Álvaro Navarro-Mingorance, Concha Goñi-Orayen
Objective. To determine the epidemiology and therapeutic management of patients with severe acute bronchiolitis (AB) admitted to paediatric intensive care units (PICUs) in Spain. Design. Descriptive, prospective, multicentre study. Setting. Sixteen Spanish PICUs. Patients. Patients with severe AB who required admission to any of the participating PICUs over 1 year. Interventions. Both epidemiological variables and medical treatment received were recorded. Results. A total of 262 patients were recruited; 143 were male (54...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28418689/an-official-american-thoracic-society-workshop-report-chemical-inhalational-disasters-biology-of-lung-injury-development-of-novel-therapeutics-and-medical-preparedness
#5
Eleanor M Summerhill, Gary W Hoyle, Sven-Eric Jordt, Bronwen J Jugg, James G Martin, Sadis Matalon, Steven E Patterson, David J Prezant, Alfred M Sciuto, Erik R Svendsen, Carl W White, Livia Veress
This report is based upon the proceedings from the Inhalational Lung Injury Workshop jointly sponsored by the American Thoracic Society (ATS) and the National Institute of Health (NIH)/National Institute of Neurologic Disorders and Stroke (NINDS) Countermeasures Against Chemical Threats (CounterACT) program on May 21, 2013 in Philadelphia, PA. The CounterACT program facilitates research leading to the development of new and improved medical countermeasures for chemical threat agents. The workshop was initiated by the Terrorism and Inhalational Disasters (TID) Section of the Environmental, Occupational, and Population Health Assembly (EOPH) of the ATS...
April 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28414990/medical-outcomes-associated-with-prescription-opioid-abuse-via-oral-and-non-oral-routes-of-administration
#6
Jody L Green, Becki Bucher Bartelson, M Claire Le Lait, Carl L Roland, Elizabeth T Masters, Jack Mardekian, J Elise Bailey, Richard C Dart
BACKGROUND: Prescription opioid abuse and misuse is a serious and growing public health issue. While the most common form of abuse is swallowing intact tablets/capsules, some abusers manipulate, or tamper with, these medications by altering the dosage form to allow for non-oral routes of administration (e.g., injection, inhalation) in order to achieve more rapid or enhanced psychoactive effects. Because administration of opioids via non-oral routes results in greater systemic availability and more rapid central nervous system penetration, we hypothesized that death and major medical outcomes occur more frequently with non-oral routes compared to oral route alone...
March 28, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28412132/pre-existing-psychiatric-disorder-in-the-burn-patient-is-associated-with-worse-outcomes
#7
Alexandra Hudson, Sarah Al Youha, Osama A Samargandi, Justin Paletz
OBJECTIVE: To compare patient and burn characteristics between patients who had a pre-existing psychiatric diagnosis and patients who did not in a Burn Unit at an academic hospital. BACKGROUND: Psychosocial issues are common in patients recovering from a burn; however, little is known regarding hospital course and discharge outcomes in patients with a pre-existing psychiatric diagnosis presenting with a burn. Baseline medical comorbidities of burn patients have been shown to be a significant risk for in-hospital mortality...
April 12, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28410043/optimising-inhaler-technique-in-chronic-obstructive-pulmonary-disease-a-complex-issue
#8
Jo Riley, Phillip Krüger
Inhaled therapies play a central role in the management of chronic obstructive pulmonary disease (COPD); however, studies indicate that many patients do not use their inhaled medication as directed, resulting in decreased medication delivery and suboptimal disease control. Key factors that should be considered when evaluating whether patients are achieving optimal outcomes with inhaled therapies are: if patients are using a correct inhalation technique; if patients have adequate dexterity to use the prescribed inhaler; if patients have sufficient inspiratory flow rate to achieve adequate lung deposition (for dry powder inhalers); and if the inhaler is accepted by the patient...
April 13, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28408806/patient-knowledge-and-pulmonary-medication-adherence-in-adult-patients-with-cystic-fibrosis
#9
Ann Hsu-An Lin, Jennifer G Kendrick, Pearce G Wilcox, Bradley S Quon
BACKGROUND AND OBJECTIVES: Patient knowledge of lung function (ie, forced expiratory volume in 1 s [FEV1]% predicted) and the intended benefits of their prescribed pulmonary medications might play an important role in medication adherence, but this relationship has not been examined previously in patients with cystic fibrosis (CF). METHODS: All patients diagnosed with CF and without prior lung transplantation were invited to complete knowledge and self-reported medication adherence questionnaires during routine outpatient visits to the Adult CF Clinic, St Paul's Hospital, Vancouver, Canada from June 2013 to August 2014...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28406710/suboptimal-inspiratory-flow-rates-are-associated-with-chronic-obstructive-pulmonary-disease-and-all-cause-readmissions
#10
Chee H Loh, Stephen P Peters, Tina M Lovings, Jill A Ohar
RATIONALE: Dry powdered inhalers (DPIs) are prescribed after hospitalization for acute exacerbation of COPD (AECOPD). Peak inspiratory flow (PIF) affects DPI delivery. OBJECTIVES: To study the impact of PIF on readmission after hospitalization for AECOPD. METHODS: A retrospective analysis of hospitalized patients, enrolled in an AECOPD care plan, was performed. Data analyzed included PIF, age, gender, length of stay, Charlson Comorbidity Index, COPD Assessment Test (CAT) and Modified Medical Research Council score, % predicted FEV1, FVC and inspiratory capacity (IC)...
April 13, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28406337/inhaled-corticosteroid-use-in-chronic-obstructive-pulmonary-disease-and-risk-of-pneumonia-a-nested-case-control-population-based-study-in-lazio-italy-the-outpul-study
#11
Silvia Cascini, Ursula Kirchmayer, Valeria Belleudi, Lisa Bauleo, Riccardo Pistelli, Mirko Di Martino, Giulio Formoso, Marina Davoli, Nera Agabiti
Inhaled corticosteroid (ICS) use in chronic obstructive pulmonary disease (COPD) patients is associated with a reduction of exacerbations and a potential risk of pneumonia. The objective was to determine if ICS use, with or without long-acting β2-agonist, increases pneumonia risk in COPD patients. A cohort study was performed using linked hospital and drug prescription databases in the Lazio region. Patients (45+) discharged with COPD in 2006-2009 were enrolled and followed from cohort entry until first admission for pneumonia, death or study end, 31 December, 2012...
April 13, 2017: COPD
https://www.readbyqxmd.com/read/28405072/tularemia-presenting-as-pulmonary-nodules-in-an-immunocompromised-patient
#12
Tony Alias, Mohammad Kazem Fallahzadeh, Mezgebe Berhe
Tularemia is a zoonotic disease caused by Francisella tularensis that can be transmitted to humans when they handle rabbits, receive tick bites, consume contaminated water, or inhale aerosolized particles. We present the case of a 51-year-old white man with rheumatoid arthritis who was taking immunosuppressive medications and presented with tularemia. Our patient acquired the typhoidal form of tularemia, which is a severe systemic illness that manifests with fevers, headaches, myalgias, vomiting, diarrhea, and neurological symptoms, due to his immunocompromised state...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28397128/characteristics-and-treatment-of-patients-with-clinical-illness-due-to-synthetic-cannabinoid-inhalation-reported-by-medical-toxicologists-a-toxic-database-study
#13
Andrew A Monte, Diane P Calello, Roy R Gerona, Eike Hamad, Sharan L Campleman, Jeffery Brent, Paul Wax, Robert G Carlson
INTRODUCTION: Synthetic cannabinoid (SC) abuse has resulted in numerous outbreaks of severe clinical illness across the United States over the past decade. The primary objective of this study was to determine the clinical characteristics of patients abusing SC requiring bedside consultation by medical toxicologists. METHODS: This was a multicenter analysis from a prospectively collected cohort of patients presenting to medical care after synthetic cannabinoid exposure, utilizing the ToxIC Registry...
April 10, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/28397057/clinical-application-analysis-of-andrographolide-total-ester-sulfonate-injection-a-traditional-chinese-medicine-licensed-in-china
#14
Ying Zhao, Pu Huang, Zhe Chen, Si-Wei Zheng, Jin-Yang Yu, Chen Shi
Andrographolide total ester sulfonate (ATES) injection is one of the products of traditional Chinese medicine (TCM) currently used against viral infection in China. ATES injection was approved for manufacturing and marketing in January 2002. It is indicated for acute respiratory infections, tonsillitis, chronic obstructive pulmonary disease, influenza, foot and mouth disease, bronchiolitis, herpangina, mumps, infectious mononucleosis and psychosis. However, its usage also carries risk. We investigated the use of ATES at the Wuhan Union Hospital from January 2014 to December 2014 and evaluated its real-world clinical application using the hospital centralized monitoring method...
April 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/28396329/outcomes-of-patients-with-chronic-obstructive-pulmonary-disease-diagnosed-with-or-without-pulmonary-function-testing
#15
Andrea Gershon, Graham Mecredy, Ruth Croxford, Teresa To, Matthew B Stanbrook, Shawn D Aaron
BACKGROUND: A small number of people with chronic obstructive pulmonary disease (COPD) receive pulmonary function testing around the time of diagnosis. Because omitting testing increases misdiagnosis, we sought to determine whether health outcomes differed between patients whose COPD was diagnosed with or without pulmonary function testing. METHODS: We conducted a longitudinal population study of patients with physician-diagnosed COPD from 2005 to 2012 using health administrative data from Ontario, Canada...
April 10, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28395936/efficacy-of-mepolizumab-add-on-therapy-on-health-related-quality-of-life-and-markers-of-asthma-control-in-severe-eosinophilic-asthma-musca-a-randomised-double-blind-placebo-controlled-parallel-group-multicentre-phase-3b-trial
#16
Geoffrey L Chupp, Eric S Bradford, Frank C Albers, Daniel J Bratton, Jie Wang-Jairaj, Linda M Nelsen, Jennifer L Trevor, Antoine Magnan, Anneke Ten Brinke
BACKGROUND: Mepolizumab, an anti-interleukin-5 monoclonal antibody approved as add-on therapy to standard of care for patients with severe eosinophilic asthma, has been shown in previous studies to reduce exacerbations and dependency on oral corticosteroids compared with placebo. We aimed to further assess mepolizumab in patients with severe eosinophilic asthma by examining its effect on health-related quality of life (HRQOL). METHODS: We did a randomised, double-blind, placebo-controlled, parallel-group, multicentre, phase 3b trial (MUSCA) in 146 hospitals or research centres in 19 countries worldwide...
April 5, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28395575/safety-of-inhaled-long-acting-anti-muscarinic-agents-in-copd
#17
Nicola A Hanania, Suzanne C Lareau, Barbara P Yawn
Evidence-based guidelines recommend inhaled long-acting anti-muscarinic agents (LAMAs) as first-line maintenance therapy for symptomatic patients with COPD. Several LAMAs are now available for use either as monotherapy or in combination with other COPD medications, including long-acting β2-agonists (LABAs) or inhaled corticosteroids (ICS). The efficacy and long-term safety of these medications have been evaluated in multiple clinical trials and real-life studies. This review evaluates the evidence available on the safety of existing LAMAs alone or in combination with LABAs and ICS in patients with COPD...
April 20, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28394653/in-vitro-in-vivo-comparison-of-inhaled-salbutamol-dose-delivered-by-jet-nebulizer-vibrating-mesh-nebulizer-and-metered-dose-inhaler-with-spacer-during-non-invasive-ventilation
#18
Ahmed Hassan, Randa Salah Eldin, Maha M Abdelrahman, Mohamed E Abdelrahim
BACKGROUND: Patients receiving noninvasive ventilation (NIV) may benefit from medical aerosol, but most guidance on dosing with different aerosol devices is limited to in-vitro studies. The study was designed to in-vitro, ex-vivo, and in-vivo compare aerosol delivery during bilevel NIV with three types of aerosol generators: metered dose inhaler with AeroChamber-MV spacer (AC), Aerogen Pro vibrating mesh nebulizer (PRO), and Sidestream jet nebulizer (SIDE). MATERIALS AND METHOD: A bilevel ventilator with dry single limb circuit and fixed expiratory port was set in spontaneous mode with initial inspiratory and expiratory pressures of 20 and 5 cmH20, 1:3 inspiratory-expiratory ratio, and 15 breaths...
February 2017: Experimental Lung Research
https://www.readbyqxmd.com/read/28391549/disease-burden-of-mild-asthma-findings-from-a-cross-sectional-real-world-survey
#19
Bo Ding, Mark Small
INTRODUCTION: Most asthma patients have mild disease, although the burden of mild asthma is not well understood nor studied. Some evidence suggests that many patients with mild asthma experience suboptimal symptom control and exacerbations. This study characterizes the burden of illness and treatment patterns among patients with a confirmed diagnosis of mild asthma, defined as GINA Step 1 or Step 2, and residing in China, France, Germany, Italy, Japan, Spain, the United Kingdom, or the United States...
April 8, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28389258/role-of-dual-bronchodilators-in-copd-a-review-of-the-current-evidence-for-indacaterol-glycopyrronium
#20
REVIEW
Joachim H Ficker, Klaus F Rabe, Tobias Welte
In this review, we summarize the rationale for combining long-acting bronchodilators in the management of chronic obstructive pulmonary disease (COPD), and the evidence for the long-acting bronchodilator combination indacaterol/glycopyrronium (IND/GLY). Clinical practice guidelines generally recommend the use of long-acting bronchodilators in the treatment of patients with all severities of COPD, either as a first-choice or alternative-choice therapy. Combining classes of long-acting bronchodilators can result in superior improvements in lung function and clinical outcomes compared with bronchodilator monotherapy, as observed in studies of free combinations of long-acting β2-agonists (LABAs) and long-acting muscarinic antagonists (LAMAs)...
April 4, 2017: Pulmonary Pharmacology & Therapeutics
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