Appraisal of Bronchodilator Microaerosols I. Pitfalls in Ventilatory Estimation

Cohen, Bevin; McIlreath, Fred J.

doi:10.1002/j.1552-4604.1964.tb00354.x

Cited by 13 publications

(8 citation statements)

References 77 publications

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“…All of the latter had demonstrated the presence of a partial potentially reversible physiologic defect on prior isoproterenol aerosol testing [21], None had received steroids, xanthine derivatives or sympathomimetic agents for at least two weeks prior to study. …”

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confidence: 99%

Nasal Airway Resistance and the Effects of Bronchodilator Drugs in Expiratory Airflow Disorders

Cohen¹

1969

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confidence: 99%

Nasal Airway Resistance and the Effects of Bronchodilator Drugs in Expiratory Airflow Disorders

Cohen¹

1969

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“…In addition to the myriad sources of error noted in clinical trials of broncho-pulmonary drugs [3], certain specific handicaps may limit demon stration of therapeutic efficacy of inhalation agents, particularly expectorants and mucolytics [15]. Ultrasound nebulization, itself, may worsen airway resistance [13], and variations in heat [13], cold [16] and relative humidity [17] of the mist can blur estimates of drug potency.…”

Section: Discussionmentioning

confidence: 99%

“…There were 9 men and 6 women; the ages ranged from 19 to 65 years. The physiologic handicap of each patient included a potentially reversible (bronchospastic) component documented by prior acute isoproterenol aerosol testing [3].…”

Section: Methodsmentioning

confidence: 99%

Ultrasonic Nebulization of Water and Mucoevacuant Solutions in Patients with Obstructive Lung Disease

Cohen¹

1972

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The effects of two inhalations each of 100 ml of a mucoevacuant and water generated ultrasonically during separate eight-hour trials after bronchodilator aerosol priming, were assessed by the behaviour of 12 plethysmographic and spirometric indices and by the volume and dry weight of sputum produced for 15 patients with obstructive ventilatory disorders and retained secretions. The mucoevacuant was statisticallysuperior to water in improving FEF_200-1,200, R_a and R_a × V_tg values and in narrowing the FVC²-FVC¹ index of air trapping; there was suggestive evidence of the greater worth of the former in reducing control elevations in the RV/TLC ratio. Sputum volume and dry weight were both greater after mucoevacuant mist inhalation. No unwelcome clinical effects accompanied the mucoevacuant mist exposure, whereas the cough and wheezing breathlessness of two patients worsened during ultrasonic nebulization of water solutions. Symptomatic betterment accompanied the improvement in physiologic measurements of most patients during mucoevacuant trials, with the majority of the same patients showing little clinical change during the water inhalation sessions.The data suggest that the helpful changes in respiratory indices recorded may be related to mucoevacuant-induced mobilization of retained secretions and improvement in faulty bronchial catharsis.

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“…All of the patient group had demonstrated a poten tially reversible element in their expiratory airflow defect on prior isoproterenol aerosol screening [8]. None had received pharmacologic or mechanical respiratory assistance for at least two weeks before these studies.…”

Section: Methodsmentioning

confidence: 99%

The Nasal Respiratory Handicap of Expiratory Airflow Disease: The Response to Bronchodilator Aerosols

Bm¹

1970

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Fifty normal adults and 50 patients with chronic bronchitis and diffuse obstructive pulmonary emphysema, all free of nasal impediments, had lower airways and nasal resistances determined by plethysmographic subtraction; R_n was also determined by electronic posterior rhinometry. Twenty of the patients pursued a double-blind crossover trial in which isoproterenol, phenylephrine, isoproterenol-phenylephrine, and placebo were given as one dose on four consecutive days from identical hand nebulizers by a randomized arrangement. Measurements of R_a, R_n and Vtg were recorded serially for four hours after each mist inhalation; [R_a×V_tg] and R_n / R_a + R_n were calculated.Mean values for nasal, lower airways and total airways resistances were significantly higher for the patients than for the normal controls. The percent of total resistance due to the nasal compartment was significantly less for the patients, and specific airways resistance higher. Changes in [R_a×R_n] allowed a more precise ranking of aerosol effects in the drug trial than deviations in R_a alone, but neither index was as helpful as total airways resistance ([R_a + R_n]) in estimating overall patient responsiveness.The data imply that examination of changes in nasal and lower respiratory airways resistances, obtained together, are more informative and accurate than reliance upon R_a-related indices in defining the locus and total effects of therapeutic aerosols and in estimating the relative worth of the various inhalants.

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Appraisal of Bronchodilator Microaerosols I. Pitfalls in Ventilatory Estimation

Cited by 13 publications

References 77 publications

Nasal Airway Resistance and the Effects of Bronchodilator Drugs in Expiratory Airflow Disorders

Nasal Airway Resistance and the Effects of Bronchodilator Drugs in Expiratory Airflow Disorders

Ultrasonic Nebulization of Water and Mucoevacuant Solutions in Patients with Obstructive Lung Disease

The Nasal Respiratory Handicap of Expiratory Airflow Disease: The Response to Bronchodilator Aerosols

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