Speed of onset of bronchodilator response to salbutamol inhaled via different devices in asthmatics: a bioassay based on functional antagonism

Lavorini, Federico; Geri, Pietro; Mariani, Laura; Marmai, Cecilia; Maluccio, Nazzarena M.; Fontana, Giovanni

doi:10.1111/j.1365-2125.2006.02641.x

Cited by 16 publications

(3 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies quantifying the time course of salbutamol in adult asthmatic patients using nebulizers, dry powder inhalers, or pMDIs suggest that the maximum increase in FEV1 following salbutamol administration occurs between 45 and 60 min with approximately 80% of the maximal response occurring within the first 10 min. [ 5 6 7 8 9 10 11 ] Matera et al . and Lötvall et al .…”

Section: Discussionmentioning

confidence: 99%

Determining the optimal time to assess the reversibility of airway obstruction

et al. 2019

View full text Add to dashboard Cite

Context:The optimal time to interpret bronchodilator reversibility remains controversial. This time may affect a positive diagnosis and manage asthma and chronic obstructive pulmonary disease (COPD).Aims:We sought to document the time when maximum respiratory function is reached after inhalation of salbutamol and to define the optimal time of bronchodilator response to assess the reversibility or non reversibility of airway obstruction.Subjects and Methods:This prospective analytical study was spread over 8 months and included 58 patients with asthma or COPD with airway obstruction. Spirometry was performed before and at 5, 10, 15, 20, and 30 min after salbutamol inhalation (200 mcg) administered through pressurized metered-dose inhalers and large volume spacer.Results:After salbutamol inhalation, the mean individual peak bronchodilation occurred at 20 min for the forced vital capacity and at 30 min for the forced expiratory volume in 1 s. The percentage of reversible patients in our sample was guideline dependent. It increased from 53% to 67.2% when using the American Thoracic Society/European Respiratory Society definition compared to using the Global Initiative for Chronic Obstructive Lung Disease. The maximum number of reversible patients was significantly different at 20 min compared to 5 and 10 min.Conclusions:Interpreting bronchodilator reversibility after 20 min was the ideal time to judge the reversibility or nonreversibility in obstructive ventilatory disorders in adults.

show abstract

Section: Discussionmentioning

confidence: 99%

Determining the optimal time to assess the reversibility of airway obstruction

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Sabutamol via pMDI provided less protection (1.2 times increase of methacholine provocative dose) than did salbutamol administered via Diskus (Accuhaler ® ) (1.9 times increase of methacholine provocative dose) and other devices. Similarly, Lavorini et al used a moderate degree of methacholine-induced bronchoconstriction in 18 patients with intermittent asthma to show a faster bronchodilator response to salbutamol (SALB) via the pMDI (HFA134a) with the Volumatic ® spacer than via the Diskus ® (Accuhaler ® ) DPI [23].…”

Section: Diskus (Accuhaler ® ) Vs Pmdimentioning

confidence: 97%

New developments in inhaler devices within pharmaceutical companies: A systematic review of the impact on clinical outcomes and patient preferences

Ninane

Vandevoorde²,

Cataldo

et al. 2015

Respiratory Medicine

View full text Add to dashboard Cite

show abstract

“…Accounts of the development of new methods are welcome in the Journal , and Lavorini et al. contribute to this in their description of a new simple and practical challenge model to compare direct‐acting bronchodilators [19]. Perhaps this is not universally applicable, as they rightly conclude, but it should be useful in many circumstances.…”

mentioning

confidence: 99%

From pharmacology to immunopharmacology

Cohen

2006

Brit J Clinical Pharma

View full text Add to dashboard Cite

Imagine a clinical pharmacologist administering a new competitive antagonist at muscarinic receptors to a healthy volunteer. The effects are dramatic. Mydriasis and loss of accommodation, sedation, and hallucinations occur within minutes, a tachycardia develops with a shortened PR interval on the electrocardiogram, the skin becomes dry, and the body temperature rises; the volunteer complains of a very dry mouth. The clinical pharmacologist observes these effects with considerable interest but without concern. Now imagine the same clinical pharmacologist giving MDX010, an antibody-based inhibitor of the CTLA-4 receptor on T lymphocytes [1][2][3]. This antibody inhibits the receptor sites that keep autoreactive T cells suppressed when activated. Inhibition produces (after some time for the autoreactive clones to proliferate) equally dramatic effects. A hypophysitis develops and some volunteers get severe diarrhea and skin rashes, in short the symptoms of a severe autoimmune disease. These events are considerably more worrying.The question is why. After all, both occurrences are induced by an antagonist that binds to a receptor, which causes downstream effects on a cellular system. In the first case the effects are caused by anticholinergic actions in different tissues, in the second by cell proliferation and toxic effects of the cells on tissues. Both were predictable from previous knowledge of the roles of mediators in physiology and cell biology.The most important reason for feeling comfortable about administering a muscarinic receptor antagonist is of course that we know so much about it. Sir Thomas Fraser (1841-1920) started this research in Edinburgh as a result of advances in the isolation of alkaloids made in around the 1820s, when atropine, cocaine, and physostigmine were isolated from plants in their pure forms. The discovery of these extraordinary potent molecules allowed the discipline of pharmacology to flourish. With increasing knowledge about physiology this led to extensive understanding of regulation of the autonomic nervous system and neurotransmission. Many great names appear in this story [4], and a clear trail can be drawn from Otto Loewi's 'Vagusstoff', with its basis in autonomic neurotransmission, to James Black and betaadrenoceptor antagonists and to ACE inhibitors. All pharmacologists and clinical pharmacologists would agree that this area is theirs. Pharmacology books often start with the autonomic nervous system and it is one of the first things that medical students learn when they do their course in general pharmacology (at least in the small minority of medical schools where it is still taught).There is little doubt either about the momentous therapeutic innovations that were derived from this knowledge or about its value for patients with a range of diseases. This area of pharmacology is old and venerable.Immunology is a discipline that also deals with receptors, agonists, antagonists, and highly complex and fascinating second messenger systems and genetic variations. Many more disea...

show abstract

Speed of onset of bronchodilator response to salbutamol inhaled via different devices in asthmatics: a bioassay based on functional antagonism

Cited by 16 publications

References 36 publications

Determining the optimal time to assess the reversibility of airway obstruction

Determining the optimal time to assess the reversibility of airway obstruction

New developments in inhaler devices within pharmaceutical companies: A systematic review of the impact on clinical outcomes and patient preferences

From pharmacology to immunopharmacology

Contact Info

Product

Resources

About