Therapeutic effects of nebulized verapamil on chronic obstructive pulmonary disease: A randomized and double‐blind clinical trial

Bozorgmehr, Rama; Edalatifard, Maryam; Safavi, Enayat; Rahimi, Besharat; Ghorbani, Fariba; Abtahi, Hamidreza; Amini, Shahideh; Pourdowlat, Guitti

doi:10.1111/crj.13142

Cited by 5 publications

(3 citation statements)

References 29 publications

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“…A patient can soon improve his physical working capacity [ 46 ]. It is recommended to evaluate the activity of the cardiovascular system and respiration by measuring the central venous pressure in the sitting and lying position without activity and after performing the activity before and after the operation [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Physiologic function of mediastinum space

Azimi¹,

Bozorgmehr²,

Sattari³

et al. 2022

Annals of Medicine &Amp; Surgery

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Section: Discussionmentioning

confidence: 99%

Physiologic function of mediastinum space

Azimi¹,

Bozorgmehr²,

Sattari³

et al. 2022

Annals of Medicine &Amp; Surgery

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“… 134 There is also evidence of the beneficial impact of inhaled verapamil on hospitalized patients with COPD, in whom it induces a bronchodilator effect and a decrease in the dyspnea score. 135 Furthermore, inhaling verapamil improved oxygen saturation and accelerated extubation in hypoxic COPD subjects admitted to the intensive care unit. 136 There is documentation that verapamil improved pulse oximetry values (SpO 2 ) and increased FVC in outpatients with pulmonary hypertension associated with COPD, indicating its potential to address ventilation-perfusion (V̇ A /Q̇) mismatch.…”

Section: Cardiovascular Diseasementioning

confidence: 98%

Cardiovascular diseases or type 2 diabetes mellitus and chronic airway diseases: mutual pharmacological interferences

Cazzola

Rogliani

Ora

et al. 2023

Therapeutic Advances in Chronic Disease

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Chronic airway diseases (CAD), mainly asthma and chronic obstructive pulmonary disease (COPD), are frequently associated with different comorbidities. Among them, cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) pose problems for the simultaneous treatment of CAD and comorbidity. Indeed, there is evidence that some drugs used to treat CAD negatively affect comorbidity, and, conversely, some drugs used to treat comorbidity may aggravate CAD. However, there is also growing evidence of some beneficial effects of CAD drugs on comorbidities and, conversely, of the ability of some of those used to treat comorbidity to reduce the severity of lung disease. In this narrative review, we first describe the potential cardiovascular risks and benefits for patients using drugs to treat CAD and the potential lung risks and benefits for patients using drugs to treat CVD. Then, we illustrate the possible negative and positive effects on T2DM of drugs used to treat CAD and the potential negative and positive impact on CAD of drugs used to treat T2DM. The frequency with which CAD and CVD or T2DM are associated requires not only considering the effect that drugs used for one disease condition may have on the other but also providing an opportunity to develop therapies that simultaneously favorably impact both diseases.

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“…Smoking causes negative effects on lung function 5 . Gases and noxious particles especially cigarette smoking always cause an extraordinary inflammatory response to the lungs 6‐8 …”

Section: Introductionmentioning

confidence: 99%

Lung deposition and systemic bioavailability of dose delivered to smoker compared with non‐smoker COPD subjects

Mohamed

Eldin

et al. 2020

Int J Clin Pract

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Introduction Inhaled drugs are the most commonly used class of medications for COPD subjects. No studies have been performed to assess the influence of smoking on lung deposition of aerosolized medication, especially for the exacerbated COPD subject. The present study aimed to assess the influence of smoking on the lung deposition of the aerosol delivered to exacerbated COPD subjects. Methods Twenty‐four exacerbated COPD subjects using automatic continuous positive airway pressure (Auto‐CPAP), 12 smokers (six females) and 12 non‐smokers (six females) were recruited in the study. The subjects participated in the study received four salbutamol study doses; 1200 µg (12 puffs 100 µg/puff) of salbutamol emitted from pMDI canister connected to AeroChamber MV spacer; 1200 µg of salbutamol emitted from pMDI canister connected to Combihaler spacer; 1 mL of salbutamol respirable solution (5000 µg/mL) nebulized by Aerogen Solo connected to its T‐piece; and 1 mL of salbutamol respirable solution nebulized by Aerogen Solo connected to Combihaler spacer with 2 puffs salbutamol MDI (200 µg salbutamol) before nebulisation. The subjects were randomised to receive the four selected dose‐adaptor combination in a sealed envelope design on days 1, 3, 5 and 7. A washout period of 24 hours was provided between each salbutamol dosing. Auto‐CPAP was adjusted at non‐invasive ventilation mode with the integrated heated humidifier, as a source of humidity. Urine samples were provided by subjects, 30 minutes and cumulatively 24 hours post inhalation, as an index of the relative and systemic bioavailability, respectively, and aliquots were retained for salbutamol analysis using solid‐phase extraction and high‐performance liquid chromatography (HPLC). On day 2 of the study, a collecting filter was placed between the aerosol generator and the subject's mask so that the subjects would not inhale the salbutamol delivered. The same study doses and/or adapters were delivered to each subject, with filters changed with each dose‐adapter combination. Salbutamol entrained on the filter was desorbed to be analysed by the HPLC. Results Significantly higher lung deposition (30 minutes urinary salbutamol) was detected with the non‐smoker compared with smokers (P < .05). Significantly higher systemic bioavailability (pooled 24‐hour urinary salbutamol) for smokers compared with non‐smokers was found with Aerogen Solo connected to its T‐piece and CombiHaler spacer with pMDI (P < .05) only. Significantly higher amount desorbed from the ex‐vivo filter were found from pMDI with both spacers in non‐smokers (P < .05) compared with the smokers. Conclusion The study demonstrated that smoking reduced the lung deposition of inhaled salbutamol delivered by nebulizer or pMDI. However, the smoking effect on cytochrome p450 was observed to increase systemic absorption of the ingested portion of the inhaled dose. The lower lung deposition and possible higher systemic absorption should be taken into consideration while prescribing inhaled medication to COPD smokers...

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Therapeutic effects of nebulized verapamil on chronic obstructive pulmonary disease: A randomized and double‐blind clinical trial

Cited by 5 publications

References 29 publications

Physiologic function of mediastinum space

Physiologic function of mediastinum space

Cardiovascular diseases or type 2 diabetes mellitus and chronic airway diseases: mutual pharmacological interferences

Lung deposition and systemic bioavailability of dose delivered to smoker compared with non‐smoker COPD subjects

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