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https://www.readbyqxmd.com/read/28509852/inhaled-antibiotic-therapy-in-chronic-respiratory-diseases
#1
REVIEW
Diego J Maselli, Holly Keyt, Marcos I Restrepo
The management of patients with chronic respiratory diseases affected by difficult to treat infections has become a challenge in clinical practice. Conditions such as cystic fibrosis (CF) and non-CF bronchiectasis require extensive treatment strategies to deal with multidrug resistant pathogens that include Pseudomonas aeruginosa, Methicillin-resistant Staphylococcus aureus, Burkholderia species and non-tuberculous Mycobacteria (NTM). These challenges prompted scientists to deliver antimicrobial agents through the pulmonary system by using inhaled, aerosolized or nebulized antibiotics...
May 16, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28499855/electrolyte-type-and-nozzle-composition-affect-the-process-of-vibrating-membrane-nebulization
#2
Moritz Beck-Broichsitter, Nina Oesterheld
The size of airborne particles determines their deposition pattern within the lungs and therefore, the efficacy of inhalation therapy. The present study analyzed factors affecting liquid atomization performed by vibrating-membrane technology. First, the process of vibrating-membrane nebulization (eFlow(®)rapid and Aeroneb(®) Pro) was challenged with numerous inorganic salts and active pharmaceutical ingredients. All investigated samples caused a sigmoidal decrease in aerosol droplet size upon an increase in concentration...
May 9, 2017: European Journal of Pharmaceutics and Biopharmaceutics
https://www.readbyqxmd.com/read/28481631/peak-inspiratory-flow-rate-as-a-criterion-for-dry-powder-inhaler-use-in-chronic-obstructive-pulmonary-disease
#3
Donald A Mahler
Dry powder bronchodilator devices have an internal resistance. Effective use depends on the patient generating an adequate inspiratory flow to break up the powder packets into particles less than five micron in diameter that can be inhaled into the loser respiratory tract. This de-aggregation takes place inside the device before the dose leaves the inhaler; this process is increased if the acceleration is fast at the start of inhalation. Peak inspiratory flow depends on an individual's effort along with strength of the respiratory muscles, which may be compromised in those with chronic obstructive pulmonary disease due to lung hyperinflation, hypoxemia, and muscle wasting...
May 8, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28478753/antibiotic-prescription-patterns-in-spanish-cystic-fibrosis-patients-results-from-a-national-multicenter-study
#4
Juan de Dios Caballero, Rosa Girón, Rosa Del Campo, Concepción Prados, María-Isabel Barrio, Antonio Salcedo, Rafael Cantón
OBJECTIVE: Information about antibiotic prescription patterns for cystic fibrosis (CF) patients and, specifically, about inhaled treatment strategies for their management is lacking in Spain due to the absence of a national patient registry. In this study we present data about antibiotic prescription in the Spanish CF context that were obtained in a multicenter study, being inhaled treatment strategies the special focus of this work. METHODS: Twenty-four specialized CF units (12 adult, 12 pediatric) from 17 tertiary-care hospitals covering all Spanish Autonomous Communities provided sputa and clinical data from 15 consecutive patients...
May 1, 2017: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/28476135/the-effects-of-inhaled-aztreonam-on-the-cystic-fibrosis-lung-microbiome
#5
Alya A Heirali, Matthew L Workentine, Nicole Acosta, Ali Poonja, Douglas G Storey, Ranjani Somayaji, Harvey R Rabin, Fiona J Whelan, Michael G Surette, Michael D Parkins
BACKGROUND: Aztreonam lysine for inhalation (AZLI) is an inhaled antibiotic used to treat chronic Pseudomonas aeruginosa infection in CF. AZLI improves lung function and quality of life, and reduces exacerbations-improvements attributed to its antipseudomonal activity. Given the extremely high aztreonam concentrations achieved in the lower airways by nebulization, we speculate this may extend its spectrum of activity to other organisms. As such, we sought to determine if AZLI affects the CF lung microbiome and whether community constituents can be used to predict treatment responsiveness...
May 5, 2017: Microbiome
https://www.readbyqxmd.com/read/28470142/multicomponent-aerosol-particle-deposition-in-a-realistic-cast-of-the-human-upper-respiratory-tract
#6
Markus Nordlund, Miloslav Belka, Arkadiusz K Kuczaj, Frantisek Lizal, Jan Jedelsky, Jakub Elcner, Miroslav Jicha, Youri Sauser, Soazig Le Bouhellec, Stephane Cosandey, Shoaib Majeed, Grégory Vuillaume, Manuel C Peitsch, Julia Hoeng
Inhalation of aerosols generated by electronic cigarettes leads to deposition of multiple chemical compounds in the human airways. In this work, an experimental method to determine regional deposition of multicomponent aerosols in an in vitro segmented, realistic human lung geometry was developed and applied to two aerosols, i.e. a monodisperse glycerol aerosol and a multicomponent aerosol. The method comprised the following steps: (1) lung cast model preparation, (2) aerosol generation and exposure, (3) extraction of deposited mass, (4) chemical quantification and (5) data processing...
February 2017: Inhalation Toxicology
https://www.readbyqxmd.com/read/28470113/nebulized-drug-delivery-in-respiratory-medicine-what-does-the-future-hold
#7
John N Pritchard
In the later half of the 20th century, nebulized therapy was in decline, but in the 21st century the prospects for the expanded use of nebulized therapy within respiratory medicine look bright. The advent of mesh nebulizers, which combine the universal applicability of the nebulizer in the treatment of all respiratory patients with the convenience of portable inhaler use, is ideally timed to capitalize on the forecast of increased numbers of patients who will require nebulized therapy in the future. This special report will highlight some of the opportunities that the development of mesh nebulizers presents in the field of respiratory medicine...
May 4, 2017: Therapeutic Delivery
https://www.readbyqxmd.com/read/28470103/tobramycin-inhalation-powder-for-the-treatment-of-pulmonary-pseudomonas-aeruginosa-infection-in-patients-with-cystic-fibrosis-a-review-based-on-clinical-evidence
#8
Kamal Hamed, Laurie Debonnett
Chronic airway infection with Pseudomonas aeruginosa is a major cause of increased morbidity and mortality in patients with cystic fibrosis (CF). The development and widespread use of nebulized antibacterial therapies, including tobramycin inhalation solution (TIS), has led to improvements in lung function and quality of life. However, the use of nebulizers is associated with various challenges, including extended administration times and the need for frequent device cleaning and disinfection. Multiple therapies are required for patients with CF, which poses a considerable burden to patients, and adherence to the recommended treatments remains a challenge...
May 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28469943/deposition-dosages-of-three-cromolyn-forms-by-cascade-impactor
#9
Norihide Murayama, Kei Asai, Kikuno Murayama, Chihiro Kitatsuji, Satoru Doi
Among inhaled asthma therapies, the present study aimed to identify factors for selecting the type of inhalation therapy for asthma. Three methods are used to deliver inhaled cromoglycate, and the airway deposition rate was evaluated using a cascade impactor with 3 dosage forms: dry powder (DP), pressurized metered dose inhaler (pMDI), and solution (jet- and mesh-types). The percentage of particles with diameters of 2-6 μm was 17.0% for the capsule, 51.8% for pMDI, 49.0% for jet-type NE-C28, and 40.4% for mesh-type NE-U22...
2017: Journal of Drug Delivery
https://www.readbyqxmd.com/read/28448535/alpha-1-antitrypsin-supplementation-improves-alveolar-macrophages-efferocytosis-and-phagocytosis-following-cigarette-smoke-exposure
#10
Karina A Serban, Daniela N Petrusca, Andrew Mikosz, Christophe Poirier, Angelia D Lockett, Lauren Saint, Matthew J Justice, Homer L Twigg, Michael A Campos, Irina Petrache
Cigarette smoking (CS), the main risk factor for COPD (chronic obstructive pulmonary disease) in developed countries, decreases alveolar macrophages (AM) clearance of both apoptotic cells and bacterial pathogens. This global deficit of AM engulfment may explain why active smokers have worse outcomes of COPD exacerbations, episodes characterized by airway infection and inflammation that carry high morbidity and healthcare cost. When administered as intravenous supplementation, the acute phase-reactant alpha-1 antitrypsin (A1AT) reduces the severity of COPD exacerbations in A1AT deficient (AATD) individuals and of bacterial pneumonia in murine models, but the effect of A1AT on AM scavenging functions has not been reported...
2017: PloS One
https://www.readbyqxmd.com/read/28448027/dry-powder-and-nebulized-aerosol-inhalation-of-pharmaceuticals-delivered-to-mice-using-a-nose-only-exposure-system
#11
Jonathan E Phillips, Xuxia Zhang, James A Johnston
Obstructive respiratory diseases like asthma and chronic obstructive pulmonary disease (COPD) are currently treated by inhaled anti-inflammatory and bronchodilator drugs. Despite the availability of multiple treatments, both diseases are growing public health concerns. The majority of asthma patients are well controlled on current inhaled therapies but a substantial number of patients with severe asthma are not. Asthma affects an estimated 300 million people worldwide and approximately 20 percent have a severe form of the disease...
April 6, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28441181/inhaled-treprostinil-drug-delivery-during-mechanical-ventilation-and-spontaneous-breathing-using-two-different-nebulizers
#12
Donna K Parker, Shuijie Shen, Jiang Zheng, D Dunbar Ivy, Dave N Crotwell, Justin C Hotz, Robert M DiBlasi
OBJECTIVES: To determine the feasibility of delivering inhaled treprostinil during mechanical ventilation and spontaneous unassisted ventilation using the Tyvaso Inhalation System and the vibrating mesh nebulizer. We sought to compare differences in fine particle fraction, and absolute inhaled treprostinil mass delivered to neonatal, pediatric, and adult models affixed with a face mask, conventional, and high-frequency ventilation between Tyvaso Inhalation System and with different nebulizer locations between Tyvaso Inhalation System and vibrating mesh nebulizer...
April 22, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28435031/clinical-outcome-associated-with-the-use-of-different-inhalation-method-with-and-without-humidification-in-asthmatic-mechanically-ventilated-patients
#13
Islam O F Moustafa, Muhammad H E ElHansy, Moataz Al Hallag, James B Fink, Patricia Dailey, Hoda Rabea, Mohamed E A Abdelrahim
BACKGROUND: Inhaled-medication delivered during mechanical-ventilation is affected by type of aerosol-generator and humidity-condition. Despite many in-vitro studies related to aerosol-delivery to mechanically-ventilated patients, little has been reported on clinical effects of these variables. The aim of this study was to determine effect of humidification and type of aerosol-generator on clinical status of mechanically ventilated asthmatics. METHOD: 72 (36 females) asthmatic subjects receiving invasive mechanical ventilation were enrolled and assigned randomly to 6 treatment groups of 12 (6 females) subjects each received, as possible, all inhaled medication using their assigned aerosol generator and humidity condition during delivery...
April 20, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28406710/suboptimal-inspiratory-flow-rates-are-associated-with-chronic-obstructive-pulmonary-disease-and-all-cause-readmissions
#14
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/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
#15
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/28392678/an-empirical-method-to-cluster-objective-nebulizer-adherence-data-among-adults-with-cystic-fibrosis
#16
Zhe H Hoo, Michael J Campbell, Rachael Curley, Martin J Wildman
BACKGROUND: The purpose of using preventative inhaled treatments in cystic fibrosis is to improve health outcomes. Therefore, understanding the relationship between adherence to treatment and health outcome is crucial. Temporal variability, as well as absolute magnitude of adherence affects health outcomes, and there is likely to be a threshold effect in the relationship between adherence and outcomes. We therefore propose a pragmatic algorithm-based clustering method of objective nebulizer adherence data to better understand this relationship, and potentially, to guide clinical decisions...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28392618/aerosol-delivery-of-sirna-to-the-lungs-part-2-nanocarrier-based-delivery-systems
#17
Susanne R Youngren-Ortiz, Nishant S Gandhi, Laura España-Serrano, Mahavir B Chougule
In this article, applications of engineered nanoparticles containing siRNA for inhalation delivery are reviewed and discussed. Diseases with identified protein malfunctions may be mitigated through the use of well-designed siRNA therapeutics. The inhalation route of administration provides local delivery of siRNA therapeutics to the lungs for various pulmonary diseases. A siRNA delivery system can be used to overcome the barriers of pulmonary delivery, such as anatomical barriers, mucociliary clearance, cough clearance, and alveolar macrophage clearance...
2017: Kona: Powder Science and Technology in Japan
https://www.readbyqxmd.com/read/28377880/paradoxical-bronchospasm-from-benzalkonium-chloride-bac-preservative-in-albuterol-nebulizer-solution-in-a-patient-with-acute-severe-asthma-a-case-report-and-literature-review-of-airway-effects-of-bac
#18
Mathew George, Saumya Vinod Joshi, Emily Concepcion, Haesoon Lee
Nebulized bronchodilator solutions are available in the United States as both nonsterile and sterile-filled products. Sulfites, benzalkonium chloride (BAC), or chlorobutanol are added to nonsterile products to prevent bacterial growth. Bronchoconstriction from inhaled BAC is cumulative, prolonged, and correlates directly with basal airway responsiveness. The multi-dose dropper bottle of albuterol sulfate solution contains 50 μg BAC per/2.5 mg of albuterol, which may be below or at the lower limit of the threshold dose for bronchoconstriction...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28367654/a-review-of-co-milling-techniques-for-the-production-of-high-dose-dry-powder-inhaler-formulation
#19
Michael Lau, Paul M Young, Daniela Traini
Drug delivery by inhalation offers several advantages compared to other dosage forms, including rapid clinical onset, high bioavailability, and minimal systemic side effects. Drug delivery to the lung can be achieved as liquid suspensions or solutions in nebulizers and pressurized metered-dose inhalers (pMDI), or as dry powders in dry powder inhalers (DPIs). Compared to other delivery systems, DPIs are, in many cases, considered the most convenient as they are breath actuated and do not require the use of propellants...
April 19, 2017: Drug Development and Industrial Pharmacy
https://www.readbyqxmd.com/read/28341778/use-of-a-metered-dose-inhaler-compared-with-a-vibrating-mesh-nebulizer-during-mechanical-ventilation-does-it-really-matter
#20
EDITORIAL
Tim W Gilmore
No abstract text is available yet for this article.
April 2017: Respiratory Care
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