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https://www.readbyqxmd.com/read/28643178/economic-evaluation-of-tobramycin-inhalation-powder-for-the-treatment-of-chronic-pulmonary-pseudomonas-aeruginosa-infection-in-patients-with-cystic-fibrosis
#1
Srilekha Panguluri, Praveen Gunda, Laurie Debonnett, Kamal Hamed
BACKGROUND: Chronic lung infection with Pseudomonas aeruginosa occurs in approximately 50% of patients with cystic fibrosis (CF). This infection further compromises lung function, and significantly contributes to the increased healthcare costs. OBJECTIVES: Inhaled tobramycin, used to manage P. aeruginosa infection in CF patients, is available as powder (tobramycin inhalation powder, TIP) and solution (tobramycin inhalation solution, TIS). Evidence suggests increased adherence with the use of TIP over TIS...
June 22, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28634121/population-pharmacokinetics-of-tobramycin-inhalation-solution-in-pediatric-patients-with-cystic-fibrosis
#2
Xinting Wang, Stephan Koehne-Voss, SivaNaga S Anumolu, Jing Yu
Tobramycin inhalation solution (TOBI) given as a twice-daily inhalation of nebulized aerosols of 300 mg is approved for the treatment of Pseudomonas aeruginosa infection in cystic fibrosis (CF) patients over 6 years of age. To investigate tobramycin pharmacokinetics (PK) after inhalation of TOBI in pediatric CF patients below 7 years, a population PK approach was used to evaluate tobramycin PK data in patients 6 months to 44 years of age from four clinical studies. The final model used a two-compartmental, first-order absorption model with effect of body mass index on the apparent central volume of distribution...
June 17, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28627376/inhaled-salbutamol-dose-delivered-by-jet-nebulizer-vibrating-mesh-nebulizer-and-metered-dose-inhaler-with-spacer-during-invasive-mechanical-ventilation
#3
Muhammad E ElHansy, Marina Emad, Assem Fouad Mohamed El Essawy, Mohamed Bakry Al-Kholy, Maha M Abdelrahman, Amira S A Said, Raghda R S Hussein, Mohamed E Abdelrahim
BACKGROUND: Patient receiving invasive mechanical ventilation (IMV) may benefit from medical aerosol, but guidance on dosing with different aerosol devices is limited to in-vitro studies. The study was designed to compare aerosol delivery with five different types of aerosol generators during IMV. METHOD: In randomized design, 60 (30 female) mechanically ventilated chronic obstructive pulmonary disease (COPD) patients were assigned to one of 5 groups. Groups 1-4 received 5000 μg salbutamol using Aerogen Pro (PRO), Aerogen Solo (SOLO), NIVO vibrating mesh and jet nebulizers (JN), respectively, while group 5 received 800 μg (8 puffs) of salbutamol via metered dose inhaler with AeroChamber-MV (MDI-AC)...
June 13, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28614995/ease-of-use-of-tobramycin-inhalation-powder-compared-with-nebulized-tobramycin-and-colistimethate-sodium-a-crossover-study-in-cystic-fibrosis-patients-with-pulmonary-pseudomonas-aeruginosa-infection
#4
James Greenwood, Carsten Schwarz, Urte Sommerwerck, Edward F Nash, Michael Tamm, Weihua Cao, Paul Mastoridis, Laurie Debonnett, Kamal Hamed
BACKGROUND: This study assessed the ease of use of tobramycin inhalation powder (TIP) administered via T-326 inhaler versus tobramycin inhalation solution (TIS) and colistimethate sodium (COLI), both administered via nebulizers, for the treatment of chronic pulmonary Pseudomonas aeruginosa infection in patients with cystic fibrosis (CF). METHODS: A real-world, open-label, crossover, interventional phase IV study was conducted in CF patients aged ⩾6 years with forced expiratory volume in 1 second (FEV1) ⩾25% to ⩽90% predicted...
July 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28598050/consensus-document-on-home-nebulization-for-maintenance-treatment-of-obstructive-airway-diseases-a-joint-initiative-by-the-national-allergy-asthma-bronchitis-institute-naabi-and-chest-research-foundation-crf
#5
Aloke G Ghoshal, Sundeep Salvi, Raja Dhar, Randeep Guleria, Ashok Mahashur, Anshuman Mukhopadhyay, Rmpl Ramanathan
Recent years have seen an increase in the use of nebulizers for delivering maintenance therapy in obstructive airway diseases (OADs) such as asthma and chronic obstructive pulmonary disease (COPD). The probable factors associated with this increase at home are: convenience of drug delivery, technological advances making the nebulizer equipment more efficient and portable, increase in the prevalence of OADs and the ageing population which may impact the optimal use of handheld inhalers such as pressurized metered dose inhalers (pMDIs) and dry powder inhalers (DPIs)...
May 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28597762/the-safety-and-pharmacokinetics-of-rapid-iloprost-aerosol-delivery-via-the-breelib-nebulizer-in-pulmonary-arterial-hypertension
#6
Tobias Gessler, Hossein-Ardeschir Ghofrani, Matthias Held, Hans Klose, Hanno Leuchte, Horst Olschewski, Stephan Rosenkranz, Lueder Fels, Na Li, Dawn Ren, Andreas Kaiser, Marcus-Hillert Schultze-Mosgau, Bernhard Müllinger, Beate Rohde, Werner Seeger
The BREELIB nebulizer was developed for iloprost to reduce inhalation times for patients with pulmonary arterial hypertension (PAH). This multicenter, randomized, unblinded, four-part study compared inhalation time, pharmacokinetics, and acute tolerability of iloprost 5 µg at mouthpiece delivered via BREELIB versus the standard I-Neb nebulizer in 27 patients with PAH. The primary safety outcome was the proportion of patients with a maximum increase in heart rate (HR) ≥ 25% and/or a maximum decrease in systolic blood pressure ≥ 20% within 30 min after inhalation...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28588117/aerosol-delivery-through-adult-high-flow-nasal-cannula-with-heliox-and-oxygen
#7
Patricia A Dailey, Robert Harwood, Kyle Walsh, James B Fink, Tina Thayer, Greg Gagnon, Arzu Ari
BACKGROUND: Heliox (helium-oxygen mixture) has been shown to reduce turbulence and improve aerosol delivery in a range of clinical settings. We questioned whether heliox as compared with oxygen via high-flow nasal cannula (HFNC) would affect aerosol delivery. We hypothesized that heliox would have a significant effect on aerosol delivery as compared with oxygen with both quiet and distressed breathing patterns. METHODS: A vibrating mesh nebulizer was placed at the inlet of a humidifier via HFNC with small adult cannula distal to the heated-wire circuit with prongs placed into simulated nares with a T-shaped trap and absolute filter connected to a breath simulator set to adult quiet and distressed breathing parameters...
June 6, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28583257/in-vitro-and-in-vivo-comparison-of-two-nebulizers-used-for-inhaled-pentamidine-delivery
#8
Nicolas Audag, Giuseppe Liistro, Dimitri Van der Linden, Françoise Smets, Teresinha Leal, Gregory Reychler
No abstract text is available yet for this article.
June 2, 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/28570317/safety-of-nebulized-epinephrine-in-smoke-inhalation-injury
#9
Guillermo Foncerrada, Francisco Lima, Robert P Clayton, Ronald P Mlcak, Perenlei Enkhbaatar, David N Herndon, Oscar E Suman
This pilot study was conducted to profile safety of nebulized racemic epinephrine when used as a therapy for smoke inhalation injury in severely burned children. We enrolled 16 patients who were 7 to 19 years of age ([mean ± SD], 12 ± 4 years) with burns covering more than 30% of the TBSA (55 ± 17%) and smoke inhalation injury, as diagnosed by bronchoscopy at burn center admission. Patients were randomized to receive either standard of care (n = 8), which consisted of nebulized acetylcysteine, nebulized heparin, and nebulized albuterol, or to receive standard of care plus nebulized epinephrine (n = 8)...
May 16, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28509852/inhaled-antibiotic-therapy-in-chronic-respiratory-diseases
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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...
June 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
#17
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
#18
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
#19
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
#20
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
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