High Incidence of Bronchospasm with Regular Administration of Aerosolized Pentamidine

Katzman, Martin A.; Meade, William; Iglar, Karl; Rachlis, Anita; Berger, Philip K.; Chan, Charles K.

doi:10.1378/chest.101.1.79

Cited by 28 publications

(10 citation statements)

References 5 publications

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“…Aerosolized pentamidine is routinely used to reduce the incidence of Pneurnocystis carinii pneumonia in patients infected with human immunodeficiency virus. Respiratory side effects such as cough and bronchospasm are frequently observed (Katzman et al, 1992). We previously demonstrated that aerosolized pentamidine isethionate induced bronchoconstriction and airway microvascular leakage in guinea pigs.…”

Section: Introductionmentioning

confidence: 94%

Aerosolized tachykinin antagonists inhibit pentamidine‐induced bronchoconstriction in guinea pigs

Harf

Boyer

et al. 1996

Fundamemntal Clinical Pharma

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To investigate the role of tachykinins in pentamidine-induced bronchoconstriction and airway microvascular leakage in the guinea pig, we examined the effects on bronchoconstriction and microvascular leakage of the nonpeptide antagonists of NK1 and NK2 tachykinin-receptors, respectively, CP-96,345 and SR 48968. Respiratory system resistance was measured by the occlusion method in anaesthetized, tracheotomized and mechanically ventilated guinea pigs. Airway microvascular permeability was evaluated by measuring the quantity of Evans blue dye in the trachea and main bronchi. Aerosolized CP-96,345 or SR 48968 partially abolished pentamidine-induced bronchoconstriction (at 5 to 30 mg/mL pentamidine; 60 breaths) whereas the combination of the two prevented it. In contrast, CP-96,345 and SR 48968 did not prevent the increase in airway microvascular permeability induced by pentamidine (50 mg/mL; 90 breaths) whether they were administered separately or together, by aerosol or intravenously. These results demonstrate that in the guinea pig, pentamidine-induced bronchoconstriction is mediated through both NK1 and NK2 tachykinin-receptor activation and that when directly administered into the airways, tachykinin antagonists effectively prevent pentamidine-induced bronchoconstriction.

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Section: Introductionmentioning

confidence: 94%

Aerosolized tachykinin antagonists inhibit pentamidine‐induced bronchoconstriction in guinea pigs

Harf

Boyer

et al. 1996

Fundamemntal Clinical Pharma

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“…56, 57, 67, 68, 71, 74-76, 79, 88-91 Polymyxin and pentamidine appear to have a higher frequency of adverse events than other agents 86-88, 92, 93 and may cause more severe events such as bronchospasm. 81,[91][92][93] Aerosolized polymyxin caused respiratory distress leading to unconsciousness. 94 Systemic side effects such as increased liver function tests, nausea, rash, and neutropenia are less common but were reported with aerosolized pentamidine.…”

Section: Drug-related Effectsmentioning

confidence: 99%

“…Although results vary, ␤-agonists appear to be the most effective agents for pretreatment. 68,87,92,93,97 Albuterol is superior to cromolyn and equivalent to ipratropium in blunting falls in pulmonary function tests precipitated by aerosolized drugs. 92,98 Albuterol has been studied more widely for this indication and is recommended as the agent of choice.…”

Section: Drug-related Effectsmentioning

confidence: 99%

“…Some patients, especially asthmatics, may experience bronchospasm not responsive to albuterol. 76,93,97 Data conflict as to whether a history of asthma predicts which patients will not tolerate aerosolized antimicrobials, 92,93,97 but pretreatment of asthmatic patients with albuterol seems prudent. Because of the high frequency of adverse effects with polymyxin and pentamidine, pretreatment with nebulized albuterol is recommended.…”

Section: Drug-related Effectsmentioning

confidence: 99%

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Aerosolized Antimicrobial Therapy in Acutely Ill Patients

Wood

Boucher

2000

Pharmacotherapy

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Recent data are sparking renewed interest in therapy with aerosolized antimicrobials in critically ill patients as well as other populations such as those with neutropenia, human immunodeficiency virus infection, and cystic fibrosis. Pneumonia is a common complication in these patients and is associated with substantial morbidity and increased mortality. Clinical trials evaluated aerosolized antimicrobials for the prevention and treatment of pneumonia in hospitalized patients. In addition, factors that affect the pulmonary deposition of aerosolized drugs in mechanically ventilated patients were identified.

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“…However, local side effects including alteration in taste, cough and bronchospasm occur in 16 to 36% of patients as acute side effects (4). A significant proportion of I-IIV patients treated with AP developed bronchospasm, and spirometry reveals airflow obstruction in about 25% of subjects (5) . Some investigators have proposed that the significant decline in flow rates is sufficient to treat all patients prophylactically with bronchodilator, even in the absence of symptoms (6) .…”

mentioning

confidence: 99%

A prospective Comparison of Porta-Sonic and Fisoneb Ultrasonic Nebulizers for Administering Aerosol Pentamidine

McIvor

Flood

Lee-Pack

et al. 1994

Canadian Journal of Infectious Diseases

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High Incidence of Bronchospasm with Regular Administration of Aerosolized Pentamidine

Cited by 28 publications

References 5 publications

Aerosolized tachykinin antagonists inhibit pentamidine‐induced bronchoconstriction in guinea pigs

Aerosolized tachykinin antagonists inhibit pentamidine‐induced bronchoconstriction in guinea pigs

Aerosolized Antimicrobial Therapy in Acutely Ill Patients

A prospective Comparison of Porta-Sonic and Fisoneb Ultrasonic Nebulizers for Administering Aerosol Pentamidine

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