Aerosolized drugs for the respiratory tract:
Saved in:
| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Philadelphia [u.a.]
Saunders
1999
|
| Series: | Respiratory care clinics of North America
5,4 |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | XVI S., S. 479 - 660 Ill., graph. Darst. |
Staff View
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| 245 | 1 | 0 | |a Aerosolized drugs for the respiratory tract |c Joseph L. Rau, guest ed. |
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Record in the Search Index
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| adam_text | j AEROSOLIZED DRUGS FOR THE RESPIRATORY TRACT
CONTENTS
Foreword xiii
RICHARD D. BRANSON and NEIL R. MacINTYRE
Preface xv
JOSEPH L. RAU, JR
The Evolution of Beta Agonists 479
ROBERT ARANSON and JOSEPH L. RAU, JR
Inhaled /3 agonists have become the mainstay of bronchodilator therapy
for reactive airway diseases, either alone or in conjunction with other
medications. The history of the development of /3 agonists is a
fascinating one that spans more than 5000 years. Scientific investigation
for the past several hundred years has elucidated the physiology of
bronchoconstriction and bronchodilation. In the past decade, a wealth
of knowledge has come forth since the discovery of the /3 adrenoceptor
which, along with advances in pharmacology, have helped answer the
questions of how /3 agonists work. From these advancements, three
classes of /3 agonists have been developed: catecholamines, resorcinols,
and saligenins. The chemical structures of the more commonly used
agents in each class, their interaction with the /3 adrenoceptor, and their
beneficial and adverse effects are discussed. Review of the duration of
action of these agents may suggest a new way of classifying them into
ultrashort acting, short acting, intermediate acting, and long acting.
Anticholinergic Bronchodilators 521
THEODORE J. WITEK, JR
Antimuscarinic treatment of airway disease has a long and colorful
history leading to its present day use as an effective bronchodilator in
chronic obstructed pulmonary disease (COPD) as well as an
antisecretory drug for watery rhinorrhea. Present formulations are
limited to ipratropium bromide, a safe and effective respiratory
therapeutic. The bronchodilation from ipratropium, as documented by
RESPIRATORY CARE CLINICS OF NORTH AMERICA 5:4, December 1999
— —
spirometry, has been well established both alone and in combination
with albuterol. Evidence suggests that anticholinergics can affect other
important aspects of COPD, such as dynamic hyperinflation, and further
studies are warranted to confirm long term physiologic effects and
associated health outcomes. Finally, current development of the long
acting compound tiotropium has provided hope for the next generation
of antimuscarinic agents represented by once daily therapy.
Comparative Potency and Clinical Efficacy of
Inhaled Corticosteroids 537
H. WILLIAM KELLY
The inhaled corticosteroids (ICSs) are currently the most potent
antiinflammatory drugs available for the long term control of persistent
asthma. Physico chemical modifications of the basic steroid structure
result in pharmacodynamic and pharmacokinetic properties that confer
both enhanced topical efficacy and diminished systemic activity
compared with older corticosteroids such as prednisolone. The purpose
of this article is to compare the pharmacodynamic, pharmacokinetic,
and lung delivery differences among the products and demonstrate how
those differences translate into significant differences in the clinical
effectiveness of the ICSs.
Inhaled Nonsteroidal Anti inflammatory Medications in the
Treatment of Asthma 555
MARZENA E. KRAWIEC and SALLY E. WENZEL
Asthma is characterized by airway inflammation even in the mildest
cases. Multiple studies have confirmed evidence of significant elevations
of inflammatory cells and mediators even at baseline in the airway of
asthmatics. Cromolyn sodium (SCG) and nedocromil sodium (NS), the
nonsteroidal anti inflammatory agents are considered options for the
management of mild persistent asthma in both adults and children as
outlined by the Global Initiative for Asthma and the Expert Panel II,
National Asthma Education and Prevention Program 1997 guidelines.
These drugs may inhibit both the early and late asthmatic response,
ostensibly by stabilizing mast cells and by reducing the total number of
eosinophils and their recruitment. SCG and NS have extremely safe
profiles, making them attractive for use even in young children. In
addition to daily use for mild persistent asthma, SCG and NS are
effective inhibitors of exercise induced brochospasm (EIB). Although
these drugs are unlikely to eliminate the use of inhaled corticosteroids
in patients with more significant obstructive airway disease, they have
potentially beneficial steroid sparing effects. Thus, the cromione, SCG
and NS, are effective prophylactic drugs recommended for use in both
adults and children in the management of mild persistent asthma, EIB,
and potentially as modest steroid sparing agents.
Mucus Controlling Agents: Past and Present 575
MALCOLM KING and BRUCE K. RUBIN
Airway mucus is the secretory product of the mucous cells. The mucus
is a variable mixture of water, mucous glycoproteins, low molecular
viii
weight ions, proteins, and lipids, the physical properties of which are
important for airway defense. The factors that contribute to the physical
properties of mucus are complex, and there are several pharmacologic
strategies that potentially can serve to improve the clearability of airway
mucus. In vitro results suggest potential benefit from the additive effects
of selected combinations of mucoactive medications. Further studies are
required to confirm these findings, to perform direct assessments of
mucus clearability, and to extend the observations to patients with
various types of pulmonary diseases for which mucoactive treatments
are required.
Exogenous Surfactant Therapy in Newborns 595
RICARDO J. RODRIGUEZ and RICHARD J. MARTIN
The introduction of surfactant replacement therapy for the management
of respiratory distress syndrome (RDS) in the premature infant is one of
the major advances in neonatal intensive care. After almost 50 years of
intense research, the concerted efforts of basic scientists and clinicians
have been rewarded. Despite the remarkable effects of surfactant therapy
of RDS, the impact on the incidence of chronic lung disease has been
unclear. With the recognition of the role of surfactant inactivation in the
pathogenesis of other respiratory disorders of newborns (i.e., meconium
aspiration syndrome and pneumonia) newer applications as well as new
challenges have emerged. This article provides an overview of the
physiology of the surfactant system and the current uses of this therapy
in newborns.
Inhaled Antimicrobial Therapy 617
THOMAS O RIORDAN and MELISSA FARIS
Although antimicrobial therapy has been administered through the
inhaled route for decades, it has always been controversial. There are
relatively few accepted indications for this mode of administration.
Well controlled studies of aerosolized antibiotics in cystic fibrosis
demonstrate that tobramycin on a cyclical basis may reduce sputum
volume, bacterial counts, and improve pulmonary function. Preliminary
data indicate that inhaled antibiotic therapy of ventilator associated
tracheobronchitis may reduce sputum volume, but the clinical
significance of this finding remains to be determined. Inhaled
pentamidine is used for prophylaxis of Pneumocystis carinii in patients
with human immunodeficiency virus infection who are intolerant of oral
prophylactic agents. Ribavirin has been used for 30 years to treat
respiratory syncytial virus. The role, if any, of inhaled antifungal
therapy with amphotericin B remains undetermined.
The Pharmacology of Aerosolized Airway Challenge 633
SCOTT S. WAGERS and CHARLES G. IRVIN
Clinicians who perform and interpret airway challenge tests must
understand the pharmacology involved. This knowledge helps one
appreciate the need for certain procedures and the importance of proper
technique. Methacholine and histamine are the most commonly used
ix
airway challenge agents. The authors review the pharmacology of
methacholine and histamine airway challenge testing and discuss issues
regarding the performance and interpretation of an airway challenge test.
Cumulative Index 1999 649
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| physical | XVI S., S. 479 - 660 Ill., graph. Darst. |
| publishDate | 1999 |
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| publisher | Saunders |
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| series | Respiratory care clinics of North America |
| series2 | Respiratory care clinics of North America |
| spelling | Aerosolized drugs for the respiratory tract Joseph L. Rau, guest ed. Philadelphia [u.a.] Saunders 1999 XVI S., S. 479 - 660 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Respiratory care clinics of North America 5,4 Aérosols Traitement respiratoire Respiratory System drug therapy Aerosol Aerosoltherapie (DE-588)4211529-2 gnd rswk-swf Atemwegskrankheit (DE-588)4003360-0 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Atemwegskrankheit (DE-588)4003360-0 s Aerosoltherapie (DE-588)4211529-2 s DE-604 Rau, Joseph L. Sonstige oth Respiratory care clinics of North America 5,4 (DE-604)BV010811241 5,4 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008784696&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Aerosolized drugs for the respiratory tract Respiratory care clinics of North America Aérosols Traitement respiratoire Respiratory System drug therapy Aerosol Aerosoltherapie (DE-588)4211529-2 gnd Atemwegskrankheit (DE-588)4003360-0 gnd |
| subject_GND | (DE-588)4211529-2 (DE-588)4003360-0 (DE-588)4143413-4 |
| title | Aerosolized drugs for the respiratory tract |
| title_auth | Aerosolized drugs for the respiratory tract |
| title_exact_search | Aerosolized drugs for the respiratory tract |
| title_full | Aerosolized drugs for the respiratory tract Joseph L. Rau, guest ed. |
| title_fullStr | Aerosolized drugs for the respiratory tract Joseph L. Rau, guest ed. |
| title_full_unstemmed | Aerosolized drugs for the respiratory tract Joseph L. Rau, guest ed. |
| title_short | Aerosolized drugs for the respiratory tract |
| title_sort | aerosolized drugs for the respiratory tract |
| topic | Aérosols Traitement respiratoire Respiratory System drug therapy Aerosol Aerosoltherapie (DE-588)4211529-2 gnd Atemwegskrankheit (DE-588)4003360-0 gnd |
| topic_facet | Aérosols Traitement respiratoire Respiratory System drug therapy Aerosol Aerosoltherapie Atemwegskrankheit Aufsatzsammlung |
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