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Inhaled drug

Santiago Mencía, Alba Palacios, Miriam García, Ana M Llorente, Olga Ordóñez, Blanca Toledo, Jesús López-Herce
OBJECTIVES: To analyze the effectiveness of inhaled sevoflurane in critically ill children with challenging sedation. DESIGN: Prospective case series. SETTING: Two PICUs of university hospitals in Spain. INTERVENTIONS: Prospective observational study and exploratory investigation conducted in two PICUs in Madrid, Spain, over a 6-year period. Children treated with inhaled sevoflurane due to difficult sedation were included...
March 19, 2018: Pediatric Critical Care Medicine
Maha Al-Faqawi, Yousef Abuowda, Alaa Eldeen Elmassry, Bettina Böttcher
BACKGROUND: The frequency and severity of chronic obstructive pulmonary disease (COPD) exacerbations are the most important determinants of prognosis in COPD. The aim of this study was to assess the management of patients presenting with COPD exacerbations at the Nasser Medical Complex in the Gaza Strip and to compare the management with the Global Initiative for Chronic Obstructive Lung Disease guidelines (GOLD 2015). METHODS: We reviewed the medical records of all patients admitted to Nasser Medical Complex and diagnosed with COPD exacerbation between Jan 1, 2014, and Dec 31, 2016...
February 21, 2018: Lancet
Tomotaka Kawayama, Takashi Kinoshita, Kazuko Matsunaga, Yoshiko Naito, Jun Sasaki, Yoshikazu Tominaga, Tomoaki Hoshino
Asthma is an allergic disease characterized by chronic airway inflammation, airway hyperresponsiveness (AHR), reversibility and remodeling. Inhaled corticosteroids (ICS) are effective in many patients with asthma. However, ICS are a controlling, but not but curative treatment, and there are still many patients with refractory and difficult-to-treat asthma. The evaluation of airway inflammation by induced sputum, non-specific AHR by methacholine, and asthmatic reactions by specific allergen challenge techniques are useful not only to investigate the pathogenesis of asthma but also to help develop new drugs for asthma management...
March 16, 2018: Kurume Medical Journal
F Frati, C Incorvaia, C Cavaliere, G Di Cara, F Marcucci, S Esposito, S Masieri
The skin prick test (SPT) is the most common test for the diagnosis of allergy. SPT is performed by pricking the skin, usually in the volar surface of the forearm, with a lancet through a drop of an allergen extract and is usually the first choice test in the diagnostic workup for allergic diseases because of its reliability, safety, convenience and low cost. SPT is minimally invasive and has the advantage of testing multiple allergens in 15 to 20 min. In children, SPT is far less disturbing than venipuncture and is used to obtain a sample of serum to measure specific IgE through in vitro tests...
January 2018: Journal of Biological Regulators and Homeostatic Agents
Wai-Kay Seto, Siu-King Mak, Keith Chiu, Varut Vardhanabhuti, Ho-Fai Wong, Heng-Tat Leong, Paul S F Lee, Y C Ho, Chi-Kei Lee, Ka-Shing Cheung, Man-Fung Yuen, Wai K Leung
BACKGROUND: Recreational ketamine use has emerged as an important health and social issue worldwide. Although ketamine is associated with biliary tract damage, the clinical and radiological profiles of ketamine-related cholangiopathy have not been well-described. METHODS: We prospectively recruited consecutive Chinese individuals who used ketamine recreationally at least twice per month over 6 months in the past 2 years via a territory-wide community network of charitable organizations tackling substance abuse...
March 15, 2018: Journal of Hepatology
Rikard Pehrson, Tove Hegelund-Myrback, Danen Cunoosamy, Sara Asimus, Paul Jansson, Naimish Patel, Annika Borde, Sofia Lundin
Inhaled drugs generally aim to drive a local pharmacological effect in the lung while minimizing systemic exposure, in order to obtain efficacy in lung disease without unwanted systemic effects. Here, we demonstrate that inhaled delivery of a p38 inhibitor (AZD7624) can provide superior pharmacokinetic exposure and superior pharmacodynamic lung effects. In rats, inhaled AZD7624 had a 5 times higher dose-adjusted lung exposure compared to intravenous dosing. In healthy volunteers, LPS-induced TNFα in sputum has been shown to be significantly reduced (85%) by means of inhaled AZD7624...
March 16, 2018: Journal of Pharmacology and Experimental Therapeutics
Karina Jahnz-Różyk, Joanna Lis, Marta Warchoł, Aleksandra Kucharczyk
BACKGROUND: Allergic asthma is the most prevalent phenotype of severe asthma where treatment with omalizumab (OMB) has been proven to be particularly beneficial. In Poland, OMB therapy is available and reimbursed within a drug programme where strict inclusion and exclusion criteria are defined. The objective of this study was to present a descriptive analysis regarding the trends in outcomes (clinical, quality of life, costs) among a cohort of patients who satisfy inclusion criteria for the initiation of OMB treatment and who successfully responded to OMB according to a set of objective criteria...
March 16, 2018: BMC Pulmonary Medicine
Augustine Tee, Wai Leng Chow, Colin Burke, Guruprasad Basavarajaiah
INTRODUCTION: In light of the growing evidence base for better clinical results with the use of the dual bronchodilator indacaterol/glycopyrronium (IND/GLY) over inhaled corticosteroid-containing salmeterol/fluticasone combination (SFC), this study aimed to evaluate the cost-effectiveness of IND/GLY over SFC in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) who are at low risk of exacerbations in the Singapore healthcare setting. METHODS: A previously published patient-level simulation model was adapted for use in Singapore by applying local unit costs...
March 16, 2018: Singapore Medical Journal
L S Usmanova, M A Ziganshin, I T Rakipov, N M Lyadov, A E Klimovitskii, T A Mukhametzyanov, A V Gerasimov
Inhalation administration is a promising alternative to the invasive drug delivery methods. The particle size required for ideal drug aerosol preparation is between 1 and 3  μ m. The application of microspherical particles of solid dispersions enhances bioavailability of poorly soluble drugs due to the solubilization. In the present work, the spray drying process of the production of microspherical particles of solid dispersions of polyvinylpyrrolidone K29-32 with model hydrophobic drug, phenacetin, was optimized using the results of DSC, PXRD, and viscometry...
2018: BioMed Research International
Richard W Foltin
The reinforcing efficacy of vaporized methamphetamine HCl (0.3 mg/kg) was determined in baboons with minimal previous drug exposure. A group of 8 adult male baboons was tested prior to a group of 7 adult female baboons. Baboons were initially trained to suck on a brass stem activating a pressure-sensitive relay (i.e., puff), to receive one M&M® candy. Five of the 8 males and 6 of the 7 females learned to activate the relay. 0.05 ml of 95% ethyl alcohol containing 0.3 mg/kg methamphetamine was vaporized and delivered to the mouth of the baboon after he/she completed 2 puffs; a single candy was given after an additional 5 puffs to ensure that baboons continued puffing after the aerosol entered their mouths...
March 12, 2018: Pharmacology, Biochemistry, and Behavior
A Sicras-Mainar, S Traseira-Lugilde, T Fernández-Sánchez, R Navarro-Artieda
OBJECTIVE: To determine the persistence, exacerbations, and use of resources in patients who use inhaler treatment with fluticasone propionate/formoterol (PF/Form) in relation with other combinations of inhaled corticosteroid/long-acting β-adrenergic (ICS/LABA) at fixed doses, for the treatment of asthma in real-life practice. MATERIAL AND METHODS: Observational study conducted by reviewing medical records. The study included subjects ≥18 years of age who started treatment with ICS/LABA and who met certain inclusion/exclusion criteria...
March 12, 2018: Semergen
Patrick Darken, Paolo DePetrillo, Colin Reisner, Earl St Rose, Paul Dorinsky
The budesonide/glycopyrronium/formoterol fumarate dihydrate metered dose inhaler (BGF MDI) is an inhaled corticosteroid/long-acting muscarinic antagonist/long-acting β2 -agonist fixed-dose combination formulated with innovative co-suspension delivery technology that is in clinical development for the treatment of chronic obstructive pulmonary disease (COPD). This randomized, Phase I, single-dose, six-treatment, four-period, crossover study (NCT01980615) examined the pharmacokinetic (PK) and safety profile of three doses of BGF MDI (320/14...
March 12, 2018: Pulmonary Pharmacology & Therapeutics
Noor Hafizah Arbain, Norazlinaliza Salim, Hamid Reza Fard Masoumi, Tin Wui Wong, Mahiran Basri, Mohd Basyaruddin Abdul Rahman
Bioavailability of quercetin, a flavonoid potentially known to combat cancer, is challenging due to hydrophobic nature. Oil-in-water (O/W) nanoemulsion system could be used as nanocarrier for quercertin to be delivered to lung via pulmonary delivery. The novelty of this nanoformulation was introduced by using palm oil ester/ricinoleic acid as oil phase which formed spherical shape nanoemulsion as measured by transmission electron microscopy and Zetasizer analyses. High energy emulsification method and D-optimal mixture design were used to optimize the composition towards the volume median diameter...
March 14, 2018: Drug Delivery and Translational Research
Kelly Oliva Jorge, Raquel Conceição Ferreira, Efigênia Ferreira E Ferreira, Ichiro Kawachi, Patrícia Maria Zarzar, Isabela Almeida Pordeus
The aim of the present cross-sectional study was to examine illicit drug use and associations with socioeconomic factors as well as peer group influence among Brazilian adolescents aged 15 to 19 years. Two-stage cluster sampling was adopted, involving the random selection of public and private schools from the nine administrative districts of a Brazilian state capital and the random selection of classrooms at each school. Illicit drug use was the outcome and was measured through the question: "Have you ever used any illicit drugs (marijuana, inhalants, hypnotics, cocaine/crack, hallucinogens, amphetamines and opioids) in your life?"...
March 8, 2018: Cadernos de Saúde Pública
Mario Malerba, Matteo Nardin, Giuseppe Santini, Nadia Mores, Alessandro Radaeli, Paolo Montuschi
Maintenance pharmacological treatment for stable chronic obstructive pulmonary disease (COPD) is based on inhaled drugs, including long-acting muscarinic receptor antagonists (LAMA), long-acting β2 -adrenoceptor agonists (LABA) and inhaled corticosteroids (ICS). Inhaled pharmacological treatment can improve patients' daily symptoms and reduce decline of pulmonary function and acute exacerbation rate. Treatment with all three inhaled drug classes is reserved for selected, more severe, patients with COPD when symptoms are not sufficiently controlled by dual LABA/LAMA therapy and exacerbations are frequent...
January 2018: Therapeutic Advances in Respiratory Disease
Ziyu Zhao, Zhengwei Huang, Xuejuan Zhang, Ying Huang, Yingtong Cui, Cheng Ma, Guanlin Wang, Tim Freeman, Xiang-Yun Lu, Xin Pan, Chuanbin Wu
BACKGROUND: The hygroscopicity of raffinose carrier for dry powder inhaler (DPI) was the main obstacle for its further application. Hygroscopicity-induced agglomeration would cause deterioration of aerosolization performance of raffinose, undermining the delivery efficiency. METHODS: Cyclodextrin-raffinose binary carriers (CRBCs) were produced by spray-drying so as to surmount the above issue. Physicochemical attributes and formation mechanism of CRBCs were explored in detail...
March 13, 2018: Expert Opinion on Drug Delivery
Charlotte H Maden, David Fairman, Michelle Chalker, Maria J Costa, William A Fahy, Nadia Garman, Pauline T Lukey, Tim Mant, Simon Parry, Juliet K Simpson, Robert J Slack, Stuart Kendrick, Richard P Marshall
PURPOSE: Inhaled drug delivery is an attractive route by which to deliver drugs to lungs of patients with idiopathic pulmonary fibrosis (IPF). GSK3008348 is a potent and selective small molecule being developed as the first inhaled inhibitor of the αvβ6 integrin for the treatment of IPF. The phase 1 first-time-in-human clinical trial (NCT02612051) presented here was designed to investigate the safety, tolerability and pharmacokinetic (PK) profile of single doses of GSK3008348 in healthy participants...
March 12, 2018: European Journal of Clinical Pharmacology
Paul Gavra, André Y Denault, Yves Théoret, Louis P Perrault, France Varin
OBJECTIVES: Milrinone pulmonary administration is used currently for the treatment of pulmonary hypertension. Several methods are available: simple jet nebulization, vibrating mesh nebulization, intratracheal instillation, and intratracheal atomization. The aim of this study was to explore the concentration-effect relationship of milrinone for each of these methods. DESIGN: Observational open-label pharmacokinetic/pharmacodynamics cohort study. SETTING: Single-center, hospital animal laboratory...
January 31, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Basanth Babu Eedara, Bhamini Rangnekar, Colin Doyle, Alex Cavallaro, Shyamal C Das
Pharmacotherapy of tuberculosis is potentially more efficient when delivered by the inhaled route than by the current oral and/or parenteral routes due to the higher concentration of drug reaching the primary region of infection in the lungs. This study investigated the influence of the amino acid L-leucine alone and in combination with the phospholipid, 1,2-dipalmitoyl-sn-glycero-3-phosphatidylcholine (DPPC), on the aerosolization behaviour of the anti-TB drugs, pyrazinamide and moxifloxacin HCl. Spray dried powders of pyrazinamide (P), moxifloxacin (M) alone and in combination with 10% L-leucine (PL and ML) and 10% DPPC (PLD and MLD) were produced...
March 7, 2018: International Journal of Pharmaceutics
Ellen Heinsbroek, Rachel Glass, Claire Edmundson, Vivian Hope, Monica Desai
BACKGROUND: Higher levels of drug use have been reported in lesbian, gay, bisexual and transgender (LGBT) communities, some of which can be explained by sexualised drug use, including 'chemsex'; the use of drugs before or during planned sexual activity to sustain, enhance, disinhibit or facilitate sex. We explored injecting and non-injecting drug use by sexual behaviour among people who inject drugs (PWID) in England, Wales and Northern Ireland. METHODS: Data were used from an unlinked-anonymous survey of PWID (2013-2016), where participants recruited through services self-completed a questionnaire...
March 6, 2018: International Journal on Drug Policy
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