Optimizing Bronchodilator Therapy in Emphysema

Diaz, Philip T.; Bruns, Aaron S.; Ezzie, Michael E.; Marchetti, Nathaniel; Thomashow, Byron

doi:10.1513/pats.200708-131et

Cited by 4 publications

(4 citation statements)

References 50 publications

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“…Significant improvements in lung function were still observed 8 h after the inhalation of the first dose of formoterol in both groups, as formoterol action is expected to last for 12 h. 8,10 However, only the group that received the second dose of formoterol evolved with a significant increase in IC and a reduction of hyperinflation, confirming the existence of a formoterol dose-response curve (Fig. 2).…”

Section: Discussionmentioning

confidence: 53%

Acute and short-term effect of an extra dose of formoterol in COPD patients

Studart

Izbicki

Nery

et al. 2012

Respiratory Medicine

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Section: Discussionmentioning

confidence: 53%

Acute and short-term effect of an extra dose of formoterol in COPD patients

Studart

Izbicki

Nery

et al. 2012

Respiratory Medicine

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“…Alternative therapy which includes sulphur, coenzyme Q10, herbs (ginkgo biloba), N-acetyl-cysteine helps not only in reducing inflammation and mucus formation, but also boosts immune response. (Diaz et al, 2008) A recent medical invention using metal coils has helped in easing the suffering of emphysema patients. This is achieved by inserting slinky like metal coils to the damaged sections of the lung, restoring the elasticity and resulting in normal respiration.…”

Section: Conclusion and Remarksmentioning

confidence: 99%

Are environmental toxins responsible for biochemical and physiological changes in emphysema?

Banerjee

Mansoori²,

Soni³

2017

IJMSCI

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Emphysema is a chronic, progressive form of a lung disease. Emphysema and chronic bronchitis both are grouped within the same disease state called as COPD, i.e. chronic obstructive pulmonary disease. It is one of the prevailing cause of morbidity and mortality in both developing and industrialized countries. There are several risk factors associated with emphysema, but, cigarette smoking is predominant factor leading to pathological variations in lung function. However, significant published literature also indicates that about 15% of all the cases of emphysema is environment-related with developing countries at highest risk. Although, there are many published literature regarding the risk factors, epidemiological evidences, diagnosis, management and prevention of emphysema, but very few explains the biochemical and physiological changes associated with environmental carcinogens. This review will help in further understanding the mechanism underlying the changes.

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“…With the reduction in dyspnea and the increase in exercise tolerance, it is possible to offer a better quality of life to patients. (3) Long-acting β 2 agonists (salmeterol and formoterol) and long-acting anticholinergics (tiotropium) are the bronchodilators of choice for the maintenance treatment of patients with dyspnea that is not controlled with short-acting drugs. Various authors have endorsed the use of such treatment as monotherapy.…”

Section: Introductionmentioning

confidence: 99%

Efeito de curto prazo do tiotrópio nos portadores de DPOC em tratamento com β2-agonista

et al. 2010

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Objective: To evaluate the short-term impact of tiotropium in patients with severe or very severe COPD who complain of dyspnea despite being currently treated with other bronchodilators. Methods: A prospective study including patients with severe or very severe COPD and complaining of dyspnea at rest or on minimal exertion. Every 15 days, the bronchodilator treatment regimen was altered, from salmeterol to tiotropium to salmeterol+tiotropium. At the end of each regimen, pulmonary function tests and the six-minute walk test (6MWT) were performed. The degree of dyspnea and the ability to perform activities of daily living were also assessed. To evaluate patient ability to perform activities of daily living, we employed the London Chest Activity of Daily Living (LCADL), validated for use in Brazil. Results: We evaluated 52 patients, 30 of whom completed the study. The use of tiotropium in isolation resulted in significant improvement in dyspnea at baseline (mean Medical Research Council scale score reduced from 3.0 to 2.5) and at the end of 6MWT (mean Borg scale score reduced from 6.1 to 4.5), and the differences were significant (p < 0.05 for both). The use of the salmeterol+tiotropium combination resulted in a significant (81 mL) increase in FEV 1 and a 5.7 point improvement in the LCADL score. Conclusions: The introduction of tiotropium into the treatment of patients with severe or very severe COPD and using long-acting β 2 agonists improves pulmonary function and provides symptomatic relief, as perceived by patients in the short term. These results, obtained under real life treatment conditions, support the use of the salmeterol+tiotropium combination in specific treatment protocols for these patients.Keywords: Pulmonary disease, chronic obstructive; Bronchodilator agents; Dyspnea; Activities of daily living. ResumoObjetivo: Avaliar o impacto de curto prazo do uso de tiotrópio em pacientes com DPOC grave e muito grave com queixas de dispneia apesar do tratamento com outros broncodilatadores. Métodos: Estudo prospectivo incluindo pacientes com DPOC grave ou muito grave, com queixa de dispneia de pequenos esforços ou ao repouso. A cada 15 dias, o tratamento broncodilatador foi modificado: salmeterol, tiotrópio e associação salmeterol+tiotrópio. Ao final de cada regime, foram realizados testes de função pulmonar e teste de caminhada de seis minutos (TC6). Também foram avaliados o grau de dispneia e a capacidade de realização de atividades de vida diária. Para a avaliação das atividades de vida diária, foi utilizada a escala London Chest Activity of Daily Living (LCADL) validado para uso no Brasil. Resultados: Foram avaliados 52 pacientes. Desses, 30 completaram o estudo. A introdução de tiotrópio como monoterapia resultou em uma melhora significativa (p < 0,05) da dispneia basal (média do escore da escala do Medical Research Council de 3,0 para 2,5) e ao final do TC6 (média do escore da escala de Borg de 6,1 para 4,5), e as diferenças foram significativas (p < 0,05 para ambos). O uso da associação salmeter...

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Optimizing Bronchodilator Therapy in Emphysema

Cited by 4 publications

References 50 publications

Acute and short-term effect of an extra dose of formoterol in COPD patients

Acute and short-term effect of an extra dose of formoterol in COPD patients

Are environmental toxins responsible for biochemical and physiological changes in emphysema?

Efeito de curto prazo do tiotrópio nos portadores de DPOC em tratamento com β2-agonista

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