Summary
A double‐blind cross‐over study showed that orally taken ketotifen and inhaled DSCG have a comparable protective effect on allergen‐induced bronchoconstriction. Both drugs significantly inhibit the immediate bronchial reaction after a 3 day treatment with either 1 mg ketotifen or 20 mg DSCG four times daily. Late reactions, which occurred in three out of the ten patients, were inhibited in two of the three patients by ketotifen as by DSCG.
The changes in arterial blood gas, pulmonary function tests, leukocyte counts and complement activation were evaluated during first use and subsequent reuse of cuprophan dialyzers. The dialysate buffer was bicarbonate. Reuse of cuprophan dialyzers significantly attenuated the fall in leukocyte counts and the rise in C3a des Arg seen during first use dialysis. First use dialysis also caused a drop in arterial paO2 from 93.0 +/- 12.4 mm Hg to a nadir of 82.8 +/- 12.6 mm Hg at 60 minutes (P less than 0.01). PaO2 levels did not change when reused dialyzers were employed (93.7 +/- 12.2 before dialysis and 96.4 +/- 15.2 mm Hg at 60 minutes, P greater than 0.05). Intradialytic paO2 curves obtained during first use and reuse were significantly different by variance analysis (P less than 0.001). There was also a significant decline in lung diffusion capacity (DLCO, from 30.70 +/- 8.89 to 23.77 +/- 7.76 ml/min X mm Hg, P less than 0.01) and transfer factor (KCO, from 6.07 +/- 1.97 to 5.65 +/- 2.13 ml/min X mm Hg, P less than 0.01), during first use at one hour after initiation of dialysis. This decrease was entirely prevented during reuse, (P less than 0.001 vs. first use by variance analysis). Percentual changes in leukocyte counts and C3a des Arg concentration on one hand, and in paO2, DLCO and KCO on the other were significantly correlated to each other. Other factors with a possible influence on intradialytic pulmonary function such as ultrafiltration volume, dialysate buffer composition, evolution of intradialytic blood pH and cardiac output, were all identical under both experimental conditions.(ABSTRACT TRUNCATED AT 250 WORDS)
Pressurized aerosols of sympathomimetic drugs are widely used in the treatment of bronchial asthma. The efficacy of this form of treatment is diminished in a number of patients by difficulties in coordination between the aerosol actuation and the inhalation. In order to improve the intrapulmonary deposition of terbutaline, an extension tube has been adapted to the regular pressurized aerosol device. In a cross-over randomized study we compared the bronchodilatory effect of increasing doses of terbutaline (250, 500 and 750 μg at 25-min intervals) either delivered by the regular pressurized aerosol device or by the device with the extension tube. The study was performed on 11 adult patients with reversible airways obstruction. Spirometry, body plethysmography and flow volume curves were performed. The onset of the bronchodilatory effect of a single dose of 250 μg terbutaline was more rapid after delivery via the extension tube. The addition of the extension tube caused a significantly higher bronchodilator efficacy of aerosolized terbutaline on the small airways. Our results show that the addition of an extension tube improves the bronchodilator efficacy of terbutaline delivered from a pressurized aerosol.
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