Effect of indacaterol on arterial blood gases in patients suffering from acute exacerbation of COPD

Rogliani, Paola; Ora, Josuel; Ciaprini, Chiara; Senis, Lucia; Stirpe, Emanuele; Cazzola, Mario

doi:10.1016/j.rmed.2013.10.022

Cited by 6 publications

(3 citation statements)

References 26 publications

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“…A proof of concept [ 44 ] performed in AECOPD patients having a mild-to-moderate worsening of dyspnea demonstrated that an early treatment with doubling dose of a combination of a LABA (Salmeterol) plus an inhaled corticosteroid (ICS, Fluticasone Propionate) for 10 days has a potential effect avoiding the requirement of prednisone within 30 days of the onset. In a single-center, open-label, randomized, crossover, and single-blind trial on 12 hospitalized AECOPD patients, a recent study exploring the acute effect of indacaterol found a significant mean increase in FEV 1 and forced vital capacity (FVC), with the highest increase at the dose of 300 mg; however, transient episodes of oxygen desaturation were observed in some patients with relatively well-preserved PaO 2 (− 5.9 mmHg [95% CI -1.4 to − 10.4] and − 6.2 mmHg [95% CI -2.7 to − 9.8] in the mean peak in PaO 2 over 6 h in the group treated with indacaterol 150 mg and indacaterol 300 mg, respectively) [ 45 ]. Similar increases were observed when indacaterol was administered over 5 days in the emergency department in comparison to salbutamol [ 46 ].…”

Section: Bronchodilatorsmentioning

confidence: 99%

Management of severe acute exacerbations of COPD: an updated narrative review

Crisafulli

Barbeta

Ielpo

et al. 2018

Multidiscip Respir Med

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BackgroundPatients with chronic obstructive pulmonary disease (COPD) may experience an acute worsening of respiratory symptoms that results in additional therapy; this event is defined as a COPD exacerbation (AECOPD). Hospitalization for AECOPD is accompanied by a rapid decline in health status with a high risk of mortality or other negative outcomes such as need for endotracheal intubation or intensive care unit (ICU) admission. Treatments for AECOPD aim to minimize the negative impact of the current exacerbation and to prevent subsequent events, such as relapse or readmission to hospital.Main bodyIn this narrative review, we update the scientific evidence about the in-hospital pharmacological and non-pharmacological treatments used in the management of a severe AECOPD. We review inhaled bronchodilators, steroids, and antibiotics for the pharmacological approach, and oxygen, high flow nasal cannulae (HFNC) oxygen therapy, non-invasive mechanical ventilation (NIMV) and pulmonary rehabilitation (PR) as non-pharmacological treatments. We also review some studies of non-conventional drugs that have been proposed for severe AECOPD.ConclusionSeveral treatments exist for severe AECOPD patients requiring hospitalization. Some treatments such as steroids and NIMV (in patients admitted with a hypercapnic acute respiratory failure and respiratory acidosis) are supported by strong evidence of their efficacy. HFNC oxygen therapy needs further prospective studies. Although antibiotics are preferred in ICU patients, there is a lack of evidence regarding the preferred drugs and optimal duration of treatment for non-ICU patients. Early rehabilitation, if associated with standard treatment of patients, is recommended due to its feasibility and safety. There are currently few promising new drugs or new applications of existing drugs.

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Section: Bronchodilatorsmentioning

confidence: 99%

Management of severe acute exacerbations of COPD: an updated narrative review

Crisafulli

Barbeta

Ielpo

et al. 2018

Multidiscip Respir Med

View full text Add to dashboard Cite

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“…However, capsule inhalers are a commonly used devices to efficiently deliver several types of medicaments by inhalation (25,26). In particular RS01 was superior in the aerosolization of FF in terms of drug dispersion and emitted dose compared when the same carrier-based formulation was aerosolized using HandiHaler or Turbospin devices (27,28).…”

Section: Discussionmentioning

confidence: 99%

Multivariate Analysis of Effects of Asthmatic Patient Respiratory Profiles on the In Vitro Performance of a Reservoir Multidose and a Capsule-Based Dry Powder Inhaler

et al. 2015

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PurposeThe aim of this work was to evaluate the effect of two different dry powder inhalers, of the NGI induction port and Alberta throat and of the actual inspiratory profiles of asthmatic patients on in-vitro drug inhalation performances.MethodsThe two devices considered were a reservoir multidose and a capsule-based inhaler. The formulation used to test the inhalers was a combination of formoterol fumarate and beclomethasone dipropionate. A breath simulator was used to mimic inhalatory patterns previously determined in vivo. A multivariate approach was adopted to estimate the significance of the effect of the investigated variables in the explored domain.ResultsBreath simulator was a useful tool to mimic in vitro the in vivo inspiratory profiles of asthmatic patients. The type of throat coupled with the impactor did not affect the aerodynamic distribution of the investigated formulation. However, the type of inhaler and inspiratory profiles affected the respirable dose of drugs.ConclusionsThe multivariate statistical approach demonstrated that the multidose inhaler, released efficiently a high fine particle mass independently from the inspiratory profiles adopted. Differently, the single dose capsule inhaler, showed a significant decrease of fine particle mass of both drugs when the device was activated using the minimum inspiratory volume (592 mL).

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“…In addition, indacaterol, a once-a-day (ultra)-LABA, was found to be effective in improving lung function during an acute exacerbation of COPD at the dose of 300 mg, with an effect that was similar to that obtained with high doses of nebulized salbutamol (1250 mg three times a day) (Segreti et al, 2013), although this caused transient episodes of oxygen desaturation (Rogliani et al, 2014b).…”

Section: B the Role Of Bronchodilators In The Management Of Chronic Obstructive Pulmonary Diseasementioning

confidence: 96%

Pharmacology and Therapeutics of Bronchodilators Revisited

et al. 2019

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Effect of indacaterol on arterial blood gases in patients suffering from acute exacerbation of COPD

Abstract: Indacaterol up to 300 μg is a potent bronchodilator that may induce small, transient decrease in PaO2 mainly in patients with relatively well-preserved PaO2. There appeared to be no clinical consequences of these PaO2 abnormalities in patients suffering from AECOPD.

Cited by 6 publications

References 26 publications

Management of severe acute exacerbations of COPD: an updated narrative review

Management of severe acute exacerbations of COPD: an updated narrative review

Multivariate Analysis of Effects of Asthmatic Patient Respiratory Profiles on the In Vitro Performance of a Reservoir Multidose and a Capsule-Based Dry Powder Inhaler

Pharmacology and Therapeutics of Bronchodilators Revisited

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