1.Bronchodilators.
Korean Journal of Anesthesiology 1986;19(3):203-204
No abstract available.
Bronchodilator Agents*
2.Short-acting β2-agonist prescription patterns in patients with asthma in the Philippines: Results from SABINA III
Dina V. Diaz ; Leilanie A. Nicodemus ; Evangeline L. Parena-Santiago ; Marie Elaine V. Capalla ; Ronnie Z. Samoro ; Bryna Kimberly Bayate-Jabines ; Jessie F. Orcasitas ; Miranila Hernandez-Matibag ; Ronnel S. Matibag ; Janet C. Bernardo ; Erica Frances H. Garcia ; Maarten JHI Beekman
Acta Medica Philippina 2020;54(Online):1-13
Objectives:
As asthma is a chronic inflammatory disease of the airways, anti‑inflammatory treatment should be
positioned at the forefront of guideline-directed asthma care. However, patients tend to rely on short-acting β2-
agonists (SABAs) for rapid-onset symptom relief. The impact of SABA overuse and associated clinical outcomes
have been investigated extensively in Europe and North America. Limited data are available from countries in Asia, Africa, Latin America, and the Middle East. The SABA use IN Asthma (SABINA) III program, a large multicountry, observational study, was undertaken to describe the global extent of SABA use and its potential contribution to suboptimal disease control. As part of the SABINA III study, we aimed to characterize SABA prescription collection and asthma-related clinical outcomes among patients in the Philippines.
Methods:
This nationwide, observational, cross-sectional, SABINA III study included patients (aged ≥12 years) with a documented asthma diagnosis recruited between May 2019 and January 2020 from 10 sites in the Philippines. Demographics, disease characteristics and prescribed asthma treatments, including SABA and inhaled corticosteroids (ICS) in the 12 months preceding study start, were recorded during a single visit, and transcribed onto an electronic case report form (eCRF). Patients were classified by investigator‑defined asthma severity, guided by the 2017 Global Initiative for Asthma (GINA) report and practice type, either primary or pulmonary medicine specialist care.
Results:
Of 245 patients analyzed, 63.3% were classified as having moderate-to-severe asthma (GINA steps 3−5), and most patients (63.3%) were enrolled by pulmonary medicine specialists. Overall, 33.1% (n=81) of patients had experienced ≥1 severe exacerbation in the previous 12 months and 18.4% (n=45) of patients had uncontrolled asthma. With respect to asthma treatments, a total of 6.5% (n=16), 40.4% (n=99), and 2.4% (n=6) of patients were prescribed SABA monotherapy, SABA in addition to maintenance therapy, and ICS, respectively, in the 12 months prior to their study visit. Most patients (n=156 [63.7%]) received prescriptions of fixed‑dose combinations of ICS and long-acting β2-agonists. SABA over-prescription, defined as ≥3 SABA canister prescriptions per year, was observed in 10.6% (n=21) of patients. Additionally, 25.6% (n=23) of
patients classified as having mild asthma were prescribed either nebulized SABA (n=17) or oral SABA (n=6). Nearly one-third of patients (n=75 [30.6%]) had purchased over-the-counter (OTC) SABA, and 46.9% (n=115) were prescribed antibiotics.
Conclusions
In this SABINA III Philippines study cohort, more than 10% of patients were over-prescribed SABA
canisters. Additionally, prescriptions for oral or nebulized SABA, the purchase of non-prescription (OTC) SABA,
and the high percentage of prescriptions for antibiotics warrant country-wide improvements in asthma care and management.
Asthma
;
Bronchodilator Agents
;
Prescriptions
3.Short-acting β2-agonist prescription patterns in patients with asthma in the Philippines: Results from SABINA III
Dina V. Diaz ; Leilanie A. Nicodemus ; Evangeline L. Parena-Santiago ; Marie Elaine V. Capalla ; Ronnie Z. Samoro ; Bryna Kimberly Bayate-Jabines ; Jessie F. Orcasitas ; Miranila Hernandez-Matibag ; Ronnel S. Matibag ; Janet C. Bernardo ; Erica Frances H. Garcia ; Maarten JHI Beekman
Acta Medica Philippina 2023;57(11):12-24
Objectives:
As asthma is a chronic inflammatory disease of the airways, anti-inflammatory treatment should be positioned at the forefront of guideline-directed asthma care. However, patients tend to rely on short-acting β2-agonists (SABAs) for rapid-onset symptom relief. The impact of SABA overuse and associated clinical outcomes have been investigated extensively in Europe and North America. Limited data are available from countries in Asia, Africa, Latin America, and the Middle East. The SABA use IN Asthma (SABINA) III program, a large multicountry, observational study, was undertaken to describe the global extent of SABA use and its potential contribution to suboptimal disease control. As part of the SABINA III study, we aimed to characterize SABA prescription collection and asthma-related clinical outcomes among patients in the Philippines.
Methods:
This nationwide, observational, cross-sectional, SABINA III study included patients (aged ≥12 years) with a documented asthma diagnosis recruited between May 2019 and January 2020 from 10 sites in the Philippines. Demographics, disease characteristics and prescribed asthma treatments, including SABA and inhaled corticosteroids (ICS) in the 12 months preceding study start, were recorded during a single visit, and transcribed onto an electronic case report form (eCRF). Patients were classified by investigator-defined asthma severity, guided by the 2017 Global Initiative for Asthma (GINA) report and practice type, either primary or pulmonary medicine specialist care.
Results:
Of 245 patients analyzed, 63.3% were classified as having moderate-to-severe asthma (GINA steps 3−5), and most patients (63.3%) were enrolled by pulmonary medicine specialists. Overall, 33.1% (n=81) of patients had experienced ≥1 severe exacerbation in the previous 12 months and 18.4% (n=45) of patients had uncontrolled asthma. With respect to asthma treatments, a total of 6.5% (n=16), 40.4% (n=99), and 2.4% (n=6) of patients were prescribed SABA monotherapy, SABA in addition to maintenance therapy, and ICS, respectively, in the 12 months prior to their study visit. Most patients (n=156 [63.7%]) received prescriptions of fixed-dose combina-tions of ICS and long-acting β2-agonists. SABA over-prescription, defined as ≥3 SABA canister prescriptions per year, was observed in 10.6% (n=21) of patients. Additionally, 25.6% (n=23) of patients classified as having mild asthma were prescribed either nebulized SABA (n=17) or oral SABA (n=6). Nearly one-third of patients (n=75 [30.6%]) had purchased over-the-counter (OTC) SABA, and 46.9% (n=115) were prescribed antibiotics.
Conclusions
In this SABINA III Philippines study cohort, more than 10% of patients were over-prescribed SABA canisters. Additionally, prescriptions for oral or nebulized SABA, the purchase of non-prescription (OTC) SABA, and the high percentage of prescriptions for antibiotics warrant country-wide improvements in asthma care and management.
Asthma
;
Bronchodilator Agents
;
Philippines
;
Prescriptions
4.The role of bronchodilators drug in the treatment of COPD
Journal of Medical and Pharmaceutical Information 2004;0(9):8-12
Chronical obstructive pulmonary disease (COPD), bronchus asthma and pneumonia are 3 common causes of death. Among them COPD is the leading cause of morbidity and mortality in Europa, the 4th leading cause in North America. Currently, there are 3 main groups of largely used medicaments beta 2 agonist, anticholin and methylxxanthin. With diverse pharmacological characteristics, all 3 groups also dilate the bronchus, change the diameter of air channel and the dilative pressure of the lung. They impact on the respiratory tract by 2 mechanisms: directly on the smooth muscle cell of the tract and inhibite the bronchus contraction neurologically. The mechanism and the level of their effects are differented in the treatment of bronchus asthma and COPD, in depending on each subject
Pulmonary Disease, Chronic Obstructive
;
Therapeutics
;
Bronchodilator Agents
5.Prediction of Brobchodilator Response by Using FEF25~75% in Adult Patient with a Normal Spirometry Result.
Se Hwan PARK ; Seung Yup LEE ; Seung Mo KANG ; Choon Sik SEON ; Hyun Kyung KIM ; Byoung Hoon LEE ; Jae Hyung LEE ; Sang Hoon KIM
Tuberculosis and Respiratory Diseases 2011;71(3):188-194
BACKGROUND: When patients with chronic respiratory symptoms have a normal spirometry result, it is not always easy to consider bronchial asthma as the preferential diagnosis. Forced expiratory flow between 25% and 75% of vital capacity (FEF(25~75%)) is known as a useful diagnostic value of small airway diseases. However, it is not commonly used, because of its high individual variability. We evaluated the pattern of bronchodilator responsiveness (BDR) and the correlation between FEF25~75% and BDR in patients with suspicious asthma and normal spirometry. METHODS: Among patients with suspicious bronchial asthma, 440 adult patients with a normal spirometry result (forced expiratory volume in one second [FEV1]/forced vital capacity [FVC] > or =70% & FEV1% predicted > or =80%) were enrolled. We divided this group into a positive BDR group (n=43) and negative BDR group (n=397), based on the result of BDR. A comparison was carried out of spirometric parameters with % change of FEV1 after bronchodilator (DeltaFEV1%). RESULTS: Among the 440 patients with normal spirometry, FEF(25~75%)% predicted were negatively correlated with DeltaFEV1% (r=-0.22, p<0.01), and BDR was positive in 43 patients (9.78%). The means of FEF(25~75%)% predicted were 64.0+/-14.5% in the BDR (+) group and 72.9+/-20.8% in the BDR (-) group (p<0.01). The negative correlation between FEF(25~75%)% predicted and DeltaFEV1% was stronger in the BDR (+) group (r=-0.38, p=0.01) than in the BDR (-) group (r=-0.17, p<0.01). In the ROC curve analysis, FEF(25~75%) at 75% of predicted value had 88.3% sensitivity and 40.3% specificity for detecting a positive BDR. CONCLUSION: BDR (+) was not rare in patients with suspicious asthma and normal spirometry. In these patients, FEF(25~75%)% predicted was well correlated with BDR.
Adult
;
Asthma
;
Bronchodilator Agents
;
Humans
;
ROC Curve
;
Spirometry
;
Vital Capacity
6.Efficacy and Safety of Tiotropium in the Treatment of Severe Persistent Asthma:Meta-analysis.
Li-li LOU ; Hai-hong GONG ; Ming-qiang ZHANG ; Jin-ming GAO
Acta Academiae Medicinae Sinicae 2016;38(1):62-68
OBJECTIVETo evaluate the efficacy and safety of tiotropium in treatment of severe persistent asthma.
METHODSReports of randomized controlled trials (RCTs) describing tiotropium for treatment of severe persistent asthma published from January 1946 to February 2015 were searched in Cochrane Library, ClinicalTrials.gov, PubMed, Ovid Medline, CNKI, and CSJD. The data of the included RCTs were extracted and the data quality was evaluated. Meta-analyses were performed with Revman 5.3 software.
RESULTSFive RCTs including 1433 patients were analyzed. Meta-analysis of the data showed that compared with the placebo group, tiotropium treatment significantly improved the patients' peak forced expiratory volume in one second (FEV1) [weighted mean difference (WMD): 0.13 L, 95% confidence interval (CI): 0.10-0.16 L, P<0.00001], trough FEV1 (WMD: 0.09 L, 95%CI: 0.06-0.12 L, P<0.00001), peak forced vital capacity (FVC) (WMD: 0.10 L, 95%CI: 0.06-0.14 L, P<0.00001), trough FVC (WMD: 0.12 L, 95%CI: 0.08-0.17 L, P<0.00001), morning peak expiratory flow (PEF) (WMD: 9.21 L/min, 95%CI: 4.2-14.23 L/min, P=0.0003), evening PEF (WMD: 22.06 L/min, 95%CI 13.05-31.08 L/min, P<0.00001). The scores of asthma control questionnaire (ACQ) (WMD: 0.01, 95% CI: -0.07-0.09, P=0.86) or asthma quality of life questionnaire (AQLQ)(WMD: 0.06, 95% CI:-0.18-0.06, P=0.33) were not affected by tiotropium. No significant difference with adverse events between tiotropium group and placebo group were reported in these included studies (P>0.05).
CONCLUSIONSTiotropium for severe persistent asthma treatment can improve FEV1, FVC, and PEF but may not improve the quality of life of the patients. Tiotropium is well tolerated and can be an add-on therapy for severe persistent asthma.
Asthma ; Bronchodilator Agents ; Humans ; Quality of Life ; Tiotropium Bromide
7.A Case of Psychogenic Cough.
Kyung Hwa RHEE ; Seung Jeong HAN ; Ji Eun OH ; Dae Hyun LIM ; Jeong Hee KIM ; Byong Kwan SON
Pediatric Allergy and Respiratory Disease 2005;15(3):300-304
Chronic cough-defined as a cough that persists for more than 3 weeks-is one of the most common symptoms during childhood that requires evaluation of causes and appropriate management, because it can be very disturbing to daily activities at home and school. Besides asthma, postnasal drip syndrome, post infectious cough, chronic bronchitis, gastroesophageal reflux disease and congenital anomaly, psychogenic factors are known to be possible causes of chronic cough in children. "Habit cough" and "respiratory tic" are different names given to psychogenic coughs. Psychogenic cough is croupy, loud, and unresponsive to antitussives or bronchodilators. It becomes more noticeable to attention and disappears during sleep. Over 90% of cases of psychogenic cough have been reported in patients under 18 years of age and its diagnosis is often delayed due to the time consumed for exclusion of other underlying organic disorders and the recognition of psychogenic factors as an etiology. We report on the case of an 11-year-old boy who presented with chronic cough of a barking nature and was diagnosed as having psychogenic cough by characteristics and 24-hour monitoring of cough frequency and who was treated by psychological interview.
Antitussive Agents
;
Asthma
;
Bronchitis, Chronic
;
Bronchodilator Agents
;
Child
;
Cough*
;
Diagnosis
;
Gastroesophageal Reflux
;
Humans
;
Interview, Psychological
;
Male
8.The Effect of Halothane and Enflurane on the Contraction of Bronchial Smooth Muscle Induced by Histamine in Rabbits.
Jae Yong SHIM ; Ou Kyoung KWON
Korean Journal of Anesthesiology 2000;39(6):849-853
BACKGROUND: Inhalation anesthetics are known to be bronchodilators. However there are several reports that these effects are not consistant, and depend on the way of experiments. Some reports showed that inhalation anesthetics don't affect broncheal smooth mucle contraction. So, we tried to evaluate the effects of inhalation anesthetics on the histamine induced contraction of broncheal smooth muscles in rabbits. METHODS: Isolated broncheal rings of rabbit were suspended in a Tyrode's solution. Contractions were recorded isometrically using a transducer. Cumulative dose responses of histamine (10(-6), 10(-5) & 10(-4) Mol, histamine group) were observed and also cumulative dose responses of histamine with halothane and enflurane administration (0.5 MAC & 1 MAC) were evaluated. RESULTS: A contraction by histamine was weakened with enflurane administration, but with halothane, the contraction was slightly weakened at 0.5 MAC and no changes were observed at 1.0 MAC compared to a contraction induced by histamine. CONCLUSIONS: At 0.5 MAC of halothane, a contraction induced by histamine was slightly weakened, but at 1 MAC, no changes of contraction occurred. However enflurane weakened the contraction at 0.5 MAC and 1 MAC. It showed that in vitro studies of the direct effect of inhalation anesthetics on smooth muscle contraction are different from the results of in vivo study reports.
Anesthetics, Inhalation
;
Bronchodilator Agents
;
Enflurane*
;
Halothane*
;
Histamine*
;
Muscle, Smooth*
;
Rabbits*
;
Transducers
9.Positioning of Long-Acting Muscarinic Antagonists in the Management of Asthma.
Allergy, Asthma & Immunology Research 2017;9(5):386-393
Despite a range of efficacious therapies for asthma, including inhaled corticosteroids (ICS) and long-acting β₂-agonists (LABA), a significant proportion of patients have poor asthma control and retain a risk of future worsening of their symptoms. Long-acting muscarinic antagonist (LAMA) bronchodilators offer a well-tolerated, efficacious, and cost-effective add-on to a patient's treatment. Of the LAMAs currently under investigation or available for the treatment of asthma, evidence from a comprehensive clinical trial program in adults and children shows that once-daily treatment with tiotropium provides benefits for patients with uncontrolled asthma despite the use of ICS and LABAs. Tiotropium is included in the Global Initiative for Asthma (GINA) strategy document as an add-on therapy option for patients at Step 4 or 5 with a history of asthma exacerbations. Tiotropium Respimat® has demonstrated safety and efficacy in patients with a range of disease severities, ages, and phenotypes. This review describes the evidence for the use of LAMA as add-on therapy for patients with asthma who remain uncontrolled despite the use of ICS and LABA treatments.
Adrenal Cortex Hormones
;
Adult
;
Asthma*
;
Bronchodilator Agents
;
Child
;
Humans
;
Muscarinic Antagonists*
;
Phenotype
;
Tiotropium Bromide
10.Fractional Exhaled Nitric Oxide and Impulse Oscillometry in Children With Allergic Rhinitis.
Yoon Hee KIM ; Hyun Bin PARK ; Min Jung KIM ; Hwan Soo KIM ; Hee Seon LEE ; Yoon Ki HAN ; Kyung Won KIM ; Myung Hyun SOHN ; Kyu Earn KIM
Allergy, Asthma & Immunology Research 2014;6(1):27-32
PURPOSE: Airway inflammation, bronchial hyper-responsiveness (BHR), and bronchodilator response (BDR) are representative characteristics of asthma. Because allergic rhinitis (AR) is a risk factor for asthma development, we evaluated these 3 characteristics in AR using measurement of fractional exhaled nitric oxide (FeNO), a methacholine challenge test (MCT), and impulse oscillometry (IOS). METHODS: This study included 112 children with asthma (asthma group), 196 children with AR (AR group), and 32 control subjects (control group). We compared pulmonary function parameters and FeNO levels among the 3 groups. The AR group was subdivided into 2 categories: the AR group with BHR and the AR group without, and again pulmonary function and FeNO levels were compared between the 2 subgroups. RESULTS: FeNO levels were more increased in the AR and asthma groups than in the control group; within the AR group, FeNO was higher in the AR group with BHR than in the AR group without. The BDR was more increased in the AR group than in the control group when percent changes in reactance at 5 Hz (Delta X5) and reactance area (Delta AX) were compared. In the AR group, however, there was no difference in Delta X5 and Delta AX between the AR group with BHR and the AR group without. CONCLUSIONS: Reversible airway obstruction on IOS and elevated FeNO levels were observed in children with AR. Because elevated FeNO levels can indicate airway inflammation and because chronic inflammation may lead to BHR, FeNO levels may be associated with BHR in AR. IOS can be a useful tool for detecting lower airway involvement of AR independent of BHR assessed in the MCT.
Airway Obstruction
;
Asthma
;
Bronchodilator Agents
;
Child*
;
Humans
;
Inflammation
;
Methacholine Chloride
;
Nitric Oxide*
;
Oscillometry*
;
Rhinitis*
;
Risk Factors