Effect of inhaled salbutamol on mucociliary clearance in patients with chronic bronchitis

Fazio, F.; Lafortuna, Claudio L.

doi:10.1378/chest.80.6.827

Cited by 32 publications

(11 citation statements)

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“…In this respect, /^-sympathomimetics may have further beneficial effects in promoting mucociliary activity [13] and bronchial secretion [11]. We feel that the combination of an antitussive and a /^-sympathomimetic is perhaps one of the most optimal choices when cough sup pression is needed.…”

Section: Discussionmentioning

confidence: 99%

Antitussive Effect of Dextromethorphan and Dextromethorphan-Salbutamol Combination in Healthy Volunteers with Artificially Induced Cough

Karttunen¹,

Tukiainen

Silvasti³

et al. 1987

Respiration

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The antitussive effects of dextromethorphan (30 mg) + salbutamol (2 mg), dextromethorphan (30 mg) alone and placebo on artificial cough induced by citric acid were compared in 19 healthy non-smoking volunteers in a double-blind crossover study. The method using inhaled citric acid with increasing concentrations to establish the cough threshold level showed an acceptable reproducibility and proved to be suitable for comparison of antitussive drugs. The cough threshold level was assessed before as well as 90 and 180 min after each medication. After placebo the cough threshold level showed no statistically significant rise. However, significant rises were shown following dextromethorphan (p < 0.001) and the dextromethorphan-salbutamol combination (p < 0.001). Between the treatments significant differences were shown in favour of the dextromethorphan-salbutamol combination. The results indicate that salbutamol has antitussive action enhancing the effect of plain dextromethorphan

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Section: Discussionmentioning

confidence: 99%

Antitussive Effect of Dextromethorphan and Dextromethorphan-Salbutamol Combination in Healthy Volunteers with Artificially Induced Cough

Karttunen¹,

Tukiainen

Silvasti³

et al. 1987

Respiration

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“…Recent evidence have also shown that β-agonists are also able to enhance mucociliary clearance in patients with asthma (10) and chronic bronchitis (11), through increased ciliary beat frequency shown in vitro (12). However, it is important to consider both the viscosity of the mucus and frequency of mucociliary clearance, as merely increasing the ciliary beat frequency may not be effective if the mucus is too thick, as seen in patients with chronic lung diseases.…”

Section: Introductionmentioning

confidence: 99%

Combined Inhaled Salbutamol and Mannitol Therapy for Mucus Hyper-secretion in Pulmonary Diseases

Ong

Traini

Ballerin

et al. 2014

AAPS J

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Abstract. This study focuses on the co-engineering of salbutamol sulphate (SS), a common bronchodilator, and mannitol (MA), a mucolytic, as a potential combination therapy for mucus hypersecretion. This combination was chosen to have a synergic effect on the airways: the SS will act on the β 2 -receptor for relaxation of smooth muscle and enhancement of ciliary beat frequency, whilst mannitol will improve the fluidity of mucus, consequently enhancing its clearance from the lung. A series of co-spray-dried samples, containing therapeutically relevant doses of SS and MA, were prepared. The physico-chemical characteristics of the formulations were evaluated in terms of size distribution, morphology, thermal and moisture response and aerosol performance. Additionally, the formulations were evaluated for their effects on cell viability and transport across air interface Calu-3 bronchial epithelial cells, contractibility effects on bronchial smooth muscle cells and cilia beat activity using ciliated nasal epithelial cells in vitro. The formulations demonstrated size distributions and aerosol performance suitable for inhalation therapy. Transport studies revealed that the MA component of the formulation enhanced penetration of SS across the complex mucus layer and the lung epithelia cells. Furthermore, the formulation in the ratios of SS 10 −6 and MA 10 −3 M gave a significant increase in cilia beat frequency whilst simultaneously preventing smooth muscle contraction associated with mannitol administration. These studies have established that co-spray dried combination formulations of MA and SS can be successfully prepared with limited toxicity, good aerosol performance and the ability to increase ciliary beat frequency for improving the mucociliary clearance in patients suffering from hyper-secretory diseases, whilst simultaneously acting on the underlying smooth muscle.

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“…The mean (SE) durations of the observation periods before, during, and after sleep following radioaerosol inhalation were 23(5), 350 (9), 38 (6); 18 (3), 342 (8), 36 (7); and 22 (3), 357 (8), 38 (8) minutes respectively for placebo, theophylline and salbutamol. The rates of clearance for the periods before, during and after sleep following the three treatments are shown in the figure.…”

Section: Resultsmentioning

confidence: 99%

Effect of oral bronchodilators on lung mucociliary clearance during sleep in patients with asthma.

Hasani

Agnew

Pavia

et al. 1993

Thorax

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Conclusion During sleep lung mucociliary clearance in stable asthma was reduced, which is in agreement with the group's previous findings. Treatment with controlled/slow release oral bronchodilators had no effect on this reduced rate of clearance associated with sleep. (Thorax 1993;48:287-289) Lung mucociliary clearance, one of the lung's host defence clearance mechanisms, is impaired in patients with airways disease.1-4 Furthermore, lung mucociliary clearance has been shown to be reduced during sleep in healthy subjects5 and in patients with asthma,6 and this may contribute to the mucus plugging which is known to be present in the small airways of asthma sufferers.7Tracheobronchial clearance rates have been shown to be enhanced by /32 adrenergic drugs and methylxanthines.A-1 Oral slow release bronchodilators are often prescribed to patients to treat nocturnal asthma. We report a study in patients with asthma to compare the effects of controlled release salbutamol (Volmax, a /32 agonist), theophylline (Phyllocontin Forte Continus, a methylxanthine), and placebo on overnight changes in lung mucociliary clearance. Methods PATIENTSTwelve patients with asthma, six of whom were male, volunteered for the study. Three (two female) were withdrawn, two because of an exacerbation of their asthma (one during the run in period and the other during the salbutamol period), and the third because he was unable to manage without an oral bronchodilator during the run in period.The patients who completed the study had a mean(SE) age of 65(5) years, percentage predicted FEV, of 61(9)% and a tobacco consumption of 12(5) pack years (seven exsmokers and two non-smokers). Seven patients were receiving treatment with inhaled /32 agonists and corticosteroids, three of whom were taking inhaled anticholinergic drugs. One other patient was receiving inhaled sodium cromoglycate only. The ninth patient was on no medication. Five of the patients were also receiving treatment with oral bronchodilators (four methylxanthines and one a /32 agonist), which were discontinued for the one week run in period and for the duration of the trial. All nine patients had shown a 15% or greater reversibility of FEV, following the inhalation of 200 ,ug salbutamol (n = 5), or a 20% or greater difference between the maximum and minimum peak expiratory flows (PEF) obtained for that day on at least two days where the PEF had been measured on seven consecutive days (n = 6), or both.STUDY DESIGN Salbutamol (8 mg twice daily), theophylline (350 mg twice daily) and placebo tablets were compared in a double blind, randomised, crossover study of seven weeks' duration. Patients underwent a one week run in period followed by three treatment periods, each of two weeks, which were not separated by wash 287 on 11 May 2018 by guest. Protected by copyright.

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Effect of inhaled salbutamol on mucociliary clearance in patients with chronic bronchitis

Cited by 32 publications

References 0 publications

Antitussive Effect of Dextromethorphan and Dextromethorphan-Salbutamol Combination in Healthy Volunteers with Artificially Induced Cough

Antitussive Effect of Dextromethorphan and Dextromethorphan-Salbutamol Combination in Healthy Volunteers with Artificially Induced Cough

Combined Inhaled Salbutamol and Mannitol Therapy for Mucus Hyper-secretion in Pulmonary Diseases

Effect of oral bronchodilators on lung mucociliary clearance during sleep in patients with asthma.

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