Pulmonary pharmacology & therapeutics
-
Pulm Pharmacol Ther · Jan 2005
Randomized Controlled TrialA randomized clinical trial of magnesium sulphate as a vehicle for nebulized salbutamol in the treatment of moderate to severe asthma attacks.
Although it is well known that intravenous administration of MgSO4 as an adjunct to conventional therapy is effective in treating asthma attacks, the effect of nebulized MgSO4 as a vehicle for salbutamol has been less evaluated. The aim of this study was to compare the effects of nebulized salbutamol administrated through either MgSO4 or isotonic saline solution on the 'peak expiratory flow rate' (PEFR), other respiratory and clinical parameters, and hospitalization rate of patients suffering from moderate to severe asthma attacks. Twenty-six patients with asthma attack were enrolled in the study in a randomized single blind fashion. ⋯ When the treatment response was evaluated within the groups, group 2 showed statistically significant increase in PEFR (% of predicted) 1h earlier than group 1 (60th vs 120th minute, p=0.003 vs p=0.007). The mean duration of achieving target-PEFRs was 105.7+/-72.1 min for group 1 and 118.3+/-96.7 min for group 2 (p>0.05). This study suggested that the additional usage of MgSO4 to nebulized salbutamol has no beneficial effect on the treatment of asthma attacks.
-
Pulm Pharmacol Ther · Jan 2005
Clinical TrialReproducibility and validity of a Yan-style portable citric acid cough challenge.
Although many different methods of measuring cough reflex sensitivity have been published, few are simple enough to use outside of a hospital or laboratory environment. The aim of this study was to develop a simple, quick, and portable cough challenge, assess its reproducibility, and compare its results with those measured by an existing established hospital protocol. Twenty-five volunteers performed cough challenges based on an established hospital dosimeter protocol, and, on a separate occasion, by a protocol inhaling citric acid from DeVilbiss 40 hand-held nebulisers (citric acid concentrations of 10-3000 mM). ⋯ The coefficient of repeatability for the hand-held method was 0.40 log mM. Administering citric acid from DeVilbiss 40 hand-held nebulisers offers a rapid, portable, and reproducible cough challenge in healthy volunteers. The results correlate well with an existing Mefar dosimeter challenge, but give two to three times greater cough thresholds.
-
Pulm Pharmacol Ther · Jan 2005
ReviewTime to change diagnostic criteria of ARDS: towards the disease entity-based subgrouping.
Because of high mortality and morbidity, acute respiratory distress syndrome (ARDS) continues to be one of the clinical challenges for intensivists. The diagnostic criteria for ARDS published by the American-European consensus conference were over simplified and made it possible to conduct large-scale randomized controlled trails (RCTs). ⋯ The Classification of ARDS into several subgroups, which take the underlying disease into account, might limit the number of patients enrolled in an RCT. Where as this subgroup classification would enable selection of a homogeneous population of ARDS patients and may be a key to conducting more focused RCTs and, therefore, having more reliable results.
-
Pulm Pharmacol Ther · Jan 2005
ReviewBleomycin lung toxicity: who are the patients with increased risk?
Bleomycin is an antibiotic drug with anticancer properties produced by Streptomyces verticillus [Cheson BD. Pharmacology of cancer chemotherapy: miscellaneous chemotherapeutic agents. In De Vita Jr. ⋯ Fever is reported in 20-50% of patients and some of them present hyperthermia [Hay J, Shahzeidi S, Laurent G. Mechanisms of bleomycin-induced lung damage. Arch Toxicol 1991;65:81-94].
-
Pulm Pharmacol Ther · Jan 2005
ReviewThe human cathelicidin LL-37: a multifunctional peptide involved in infection and inflammation in the lung.
Antimicrobial peptides play an important role in innate immunity of the lung by acting as effector molecules in host defence against inhaled pathogens. Various families of antimicrobial peptides have been identified, including the cathelicidins. Cathelicidins are characterized by a conserved N-terminal cathelin domain and a variable C-terminal antimicrobial domain that can be released from the precursor protein after cleavage by proteinases. ⋯ In addition to killing a broad spectrum of microorganisms, LL-37 was demonstrated to display various cellular activities related to inflammation including cytotoxicity to host cells, chemotaxis, epithelial cell activation, angiogenesis and epithelial wound repair. Focussing on this recent information, this review discusses the role of LL-37 in infection and inflammation in the lung. In addition, the importance of the fact that antimicrobial peptides such as LL-37 display a range of activities for the design and development of antimicrobial peptides for therapeutic use is discussed.