Journal of aerosol medicine and pulmonary drug delivery
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J Aerosol Med Pulm Drug Deliv · Mar 2008
ReviewAerosolized antibiotics for non-cystic fibrosis bronchiectasis.
There are strong data supporting using the use of aerosolized antibiotics for the treatment of Gram-negative infections in patients with cystic fibrosis (CF). The regular use of aerosol tobramycin or colistin can decrease exacerbations of lung disease, decrease bacteria counts, and improve pulmonary function in persons with CF and Pseudomonas aeruginosa airway infection. Bronchiectasis is caused by reoccurring or continuous presence of bacteria in association with airway obstruction. ⋯ There have been only a few small studies of aerosolized antibiotics to treat pseudomonas infection in subjects with non-CF bronchiectasis. Unlike the CF experience, there does not seem to be an improvement of pulmonary function after treatment with aerosol tobramycin in this population despite a decreased sputum bacterial density and a trend toward a decrease in risk of hospitalization. Furthermore, the risk of adverse events such as bronchospasm may be more common in adults with non-CF bronchiectasis than reported in the CF population.
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J Aerosol Med Pulm Drug Deliv · Mar 2008
ReviewAppropriate face models for evaluating drug delivery in the laboratory: the current situation and prospects for future advances.
The laboratory evaluation of inhalers with facemasks for patient interface is so complex that testing without a facemask is generally undertaken, a practice that has been advocated in one standard. However, the facemask itself can profoundly influence medication delivery. A systematic review of the literature was undertaken to establish the development history of face models for the evaluation of facemasks used with inhalers and accessories. ⋯ However, it is necessary either to apply sealants or to compress the facemask beyond normal to eliminate leakage with the rigid facial structure that is incomplete above the bridge of the nose. An oral-breathing infant full-face model (ADAM) intended to be used to quantify emitted mass at the patient interface incorporates flexible facial features to overcome this limitation. There is a need to extend the flexible face approach to other models that may be developed in the future for testing facemasks, whether or not they incorporate anatomically correct realizations of the upper respiratory tract.