Furosemide Inhalation in Dyspnea of Mustard Gas-Exposed Patients: A Triple-Blind Randomized Study

Panahi, Yunes; Motiei-Langroudi, Rouzbeh; Alaeddini, Farshid; Naghizadeh, Mohammad Mehdi; Aslani, Jafar; Ghanei, Mostafa

doi:10.1080/08958370701861520

Cited by 7 publications

(2 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…123 124 However, other reports have shown no beneficial effect in patients with cancer 125 and in patients with a previous exposure to sulphur mustard. 126 It is possible that the effectiveness of inhaled furosemide may depend on the underlying lung pathology, and may not act on vagal receptors when the tracheobronchial mucosa and nerve endings are severely damaged.…”

Section: Alterations In Vagal Afferent Informationmentioning

confidence: 99%

Dyspnoea: underlying mechanisms and treatment

Nishino

2011

British Journal of Anaesthesia

View full text Add to dashboard Cite

Dyspnoea is the result of a complex interaction of physiological, psychosocial, social, and environmental factors. Although several sensory receptors located throughout the respiratory system are considered to be responsible for generation of dyspnoea, there is no afferent receptor solely responsible for the sensation of dyspnoea. Afferent information from the sensory receptors is processed at the cortex along with the respiratory motor command from the cortex and brainstem, and a mismatch between the motor command and the incoming afferent information may result in dyspnoea. Dyspnoea is not a single sensation and there are at least three distinct sensations including air hunger, work/effort, and chest tightness. Like pain, dyspnoea has at least two distinct separate dimensions, that is, a sensory and an affective dimension. Recent neuroimaging studies suggest that neural structures subserving pain and dyspnoea might be shared, and therefore the neurophysiological and psychophysical approaches used to understand pain can be applied to dyspnoea research. Although effective treatment of dyspnoea remains an elusive goal at the moment, a better understanding of the pathophysiology and neurophysiology of dyspnoea may provide a rationale for effective therapy of dyspnoea. In this context, treatment strategies in dyspnoea should be similar to those used in pain.

show abstract

Section: Alterations In Vagal Afferent Informationmentioning

confidence: 99%

Dyspnoea: underlying mechanisms and treatment

Nishino

2011

British Journal of Anaesthesia

View full text Add to dashboard Cite

show abstract

“…So, it was suggested that SM-exposed patients who had chronic bronchitis or bronchiolitis, may not benefit from furosemide to improve dyspnea. 15 Increased airway responsiveness to β-agonists is noted in asthmatics and smokers. Also, increased airway responsiveness to salbutamol in most subjects exposed to chemical warfare agents, was shown.…”

Section: Management Of Respiratory Toxic Effects and Cost-effectiveness Of Drugs Used In The Treatment Of Sulfur Mustard-induced Respiratmentioning

confidence: 99%

Evaluation of the pharmacoeconomics of drugs used for the treatment of long-term complications of sulfur mustard

et al. 2016

Self Cite

View full text Add to dashboard Cite

Sulfur mustard (SM), a cytotoxic vesicant chemical warfare agent, has powerful irritant and blistering effects on the skin, eyes and respiratory tract. Since during the Iraq-Iran war, many Iranian soldiers and civilians were exposed to SM, there are several victims still suffering from long-term cutaneous, ocular and pulmonary complications. Currently, there is no definite treatment for long-term complications of SM, and only supportive medical care is being taken to minimize the symptoms. In this study, we compared the cost-effectiveness of common drugs that are used against long-term SM-induced complications in Iranian patients. In this review article, electronic databases were checked using the following key words: sulfur mustard, lung, skin, eye, cost-effectiveness, pharmacoeconomics and treatment. Abstracts of non-English papers and proceedings of congresses on SM were also assessed. Among the studied drugs, high-dose oral N-acetyl cysteine and long-acting inhaled corticosteroids against respiratory complications, topical corticosteroids and oral antihistamines against cutaneous complications and NSAIDS and corticosteroids ophthalmic drops against ocular complications were found to be cost-effective. Usage of different drugs in the treatment of SM injuries in Iran, have imposed a significant economic burden to patients and their families because many drugs that are effective against chemical injuries are not covered by insurance. In addition, development of more effective drugs in this field is considered as an urgent demand that should be noticed by the pharmaceutical industry.

show abstract

The Effect of Aerosol Saline on Laboratory-Induced Dyspnea

O’Donnell

Lansing

Schwartzstein

et al. 2016

Lung

View full text Add to dashboard Cite

Purpose In the ‘placebo arm’ of a recent study we found that aerosol saline (sham treatment) produced substantial relief of laboratory-induced dyspnea (Breathing Discomfort – BD) in nearly half the subjects. The sham intervention included a physiological change, and instructions to subjects could have produced expectation of dyspnea relief. In the present study we attempted to discover whether the response to sham aerosol was driven by behavioral or physiological aspects of the intervention. Methods Dyspnea (air hunger) was evoked by constraining tidal volume during graded hypercapnia. We measured Petco2 vs BD relationship before and after aerosol saline. To minimize subjects’ expectations of dyspnea relief, participants in were clearly instructed that we would only deliver saline aerosol. In Protocol 1, we delivered aerosol saline with a ventilator (mimicking our prior study); in Protocol 2, we delivered aerosol without a ventilator. Results Administration of aerosol saline had little effect on BD in this group of subjects with one exception: one subject experienced appreciable reduction in BD in Protocol 1. This treatment effect was less in Protocol 2. The two most likely explanations are a) that procedures surrounding ventilator administration of aerosol produced a psychological placebo treatment effect even though the subject knew a drug was not given, b) there were behavioral changes in breathing undetected by our measurements of respiratory flow and volume that altered the subjects comfort. Conclusion When the expectation of treatment effect is minimized, a significant reduction in dyspnea in response to saline placebo is uncommon but not impossible.

show abstract

Furosemide Inhalation in Dyspnea of Mustard Gas-Exposed Patients: A Triple-Blind Randomized Study

Cited by 7 publications

References 36 publications

Dyspnoea: underlying mechanisms and treatment

Dyspnoea: underlying mechanisms and treatment

Evaluation of the pharmacoeconomics of drugs used for the treatment of long-term complications of sulfur mustard

The Effect of Aerosol Saline on Laboratory-Induced Dyspnea

Contact Info

Product

Resources

About