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Journal of the Chinese Medical... Nov 2018Transient tachypnea of the newborn (TTN) is a self-limiting disease that results from a reduction in the rate of lung fluid clearance in neonates. A delay in lung fluid... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Transient tachypnea of the newborn (TTN) is a self-limiting disease that results from a reduction in the rate of lung fluid clearance in neonates. A delay in lung fluid absorption in neonates disrupts the transition from intrauterine to extrauterine life. Use of beta-adrenergic antagonists, such as salbutamol, accelerates lung fluid clearance. The current study aimed to evaluate the effect of inhaled salbutamol on the clinical progression of TTN treatment.
METHODS
In the current triple-blind clinical trial, a total of 148 inpatients diagnosed with TTN were randomly divided into 2 groups. The treatment group (n = 74) received inhaled salbutamol and the placebo group (n = 74) received inhaled normal saline. The drug administration was started 6 h after birth and continued in the case of continued respiratory distress and the need for oxygen as adjuvant therapy for up to 72 h maximum after the initiation of treatment. To evaluate the response to treatment with inhaled salbutamol, we assessed the respiratory rate (RR), heart rate (HR), fraction of inspired oxygen (FIO2) level, and O saturation at intervals of 30 min as well as 1 h and 4 h after drug administration. The results were compared between the groups.
RESULTS
The results of the current study indicated a significant difference between the treatment and placebo groups in the treatment duration, hospitalization duration, need for continuous positive airway pressure therapy (CPAP), and time of oral feeding initiation. In addition, no complication was observed during the treatment. It is noteworthy that, following the improvement of disease symptoms and reduction of hospitalization. This reduction may decrease the treatment costs and anxiety of parents, which was associated with proper mental and economic outcomes.
CONCLUSION
Although, in the current study, drug administration was continued for 72 h maximum, the prescription of at most 4 doses of salbutamol may have had maximum efficiency in the remediation process. To evaluate the therapeutic role of inhaled salbutamol, further studies are recommended.
Topics: Administration, Inhalation; Adult; Albuterol; Continuous Positive Airway Pressure; Female; Humans; Infant, Newborn; Male; Maternal Age; Transient Tachypnea of the Newborn
PubMed: 30131296
DOI: 10.1016/j.jcma.2018.01.015 -
British Journal of Clinical Pharmacology Aug 2018Salbutamol is used in the management of obstructive bronchospasm, including that of some elite athletes. It is claimed that high salbutamol (oral) doses may also have an...
AIMS
Salbutamol is used in the management of obstructive bronchospasm, including that of some elite athletes. It is claimed that high salbutamol (oral) doses may also have an anabolic effect. Therefore, inhalation of salbutamol is restricted by the World Anti-Doping Agency (WADA) to a maximal daily dose. Urine is tested for violations, but recent cases have resulted in a debate regarding the validity of this approach. It was our aim to determine whether current approaches are sufficiently able to differentiate approved usage from violations.
METHODS
We extracted pharmacokinetic parameters from literature for salbutamol and its sulphated metabolite. From these parameters, a semi-physiological pharmacokinetic model of inhaled and orally administered salbutamol was synthesized, validated against literature data, and used to perform clinical trial simulations (n = 1000) of possible urine concentrations over time resulting from WADA-allowed and oral unacceptable dosages.
RESULTS
The synthesized model was able to predict the literature data well. Simulations showed a very large range of salbutamol concentrations, with a significant portion of virtual subjects (15.4%) exceeding the WADA threshold limit of 1000 ng ml at 1 h post-dose.
CONCLUSIONS
The observed large variability in urine concentrations indicates that determining the administered dose from a single untimed urine sample is not feasible. The current threshold inadvertently leads to incorrect assumptions of violation, whereas many violations will go unnoticed, especially when samples are taken long after drug administration. These issues, combined with the dubious assertion of its anabolic effect, leads us to conclude that the large effort involved in testing should be reconsidered.
Topics: Administration, Inhalation; Administration, Oral; Adult; Albuterol; Anabolic Agents; Biological Variation, Population; Bronchial Spasm; Doping in Sports; False Negative Reactions; False Positive Reactions; Feasibility Studies; Humans; Medical Futility; Models, Biological; Renal Elimination
PubMed: 29722428
DOI: 10.1111/bcp.13619 -
Archives of Disease in Childhood Jan 1986The bronchodilator response after five different modes of salbutamol inhalation by rotahaler was assessed in 15 asthmatic children in a double blind cross over study.... (Clinical Trial)
Clinical Trial
The bronchodilator response after five different modes of salbutamol inhalation by rotahaler was assessed in 15 asthmatic children in a double blind cross over study. Inspiratory flow rates lower than 50 litres/minute were associated with a significant reduction in response compared with flow rates higher than 60 litres/minute, but tilting the head back during inhalation and holding the breath for 10 seconds had no significant effect on bronchodilation. Peak inspiratory flow rates measured in 150 normal children and 13 asthmatic children with acute wheeze showed that many young children and many children with severe bronchoconstriction were unable to generate a sufficiently high inspiratory flow rate to obtain maximum benefit from rotahaler treatment. Children using a rotahaler should be taught to inhale as quickly as possible and not with a quiet deep breath as recommended in the instruction leaflets.
Topics: Acute Disease; Adolescent; Aerosols; Age Factors; Albuterol; Asthma; Child; Clinical Trials as Topic; Double-Blind Method; Female; Forced Expiratory Volume; Humans; Male; Respiration
PubMed: 3513714
DOI: 10.1136/adc.61.1.11 -
Respiratory Care Sep 2018A new holding chamber was designed to be used with the Aerogen Solo nebulizer to increase the aerosol emitted that reach the patient. The aim of this study was to...
BACKGROUND
A new holding chamber was designed to be used with the Aerogen Solo nebulizer to increase the aerosol emitted that reach the patient. The aim of this study was to evaluate the efficacy of this holding chamber with the nebulizer and determine its usability with other nebulizers.
METHODS
The study was divided into 2 parts. In the first part, aerosol emitted of 1 mL respirable solution (nominal dose of 5000 μg salbutamol), delivered by using the mesh nebulizer, Pro nebulizer, and jet nebulizer, connected to a T-piece or a holding chamber, was determined by using a breathing simulator set to provide a tidal volume of 500 mL, frequency of 15 breaths/min, and the inspiratory-expiratory ratio of 1:1 for adults as the quiet breathing pattern. Aerodynamic particle size characterizations were determined by using a cooled cascade impactor at an inhalation flow of 15 L/min. In the second part of the study, 12 healthy nonsmoking subjects (6 females) >18 y, with an FEV1 > 90% were enrolled. Inhaled aerosol of 1 mL respirable solution (5,000 μg salbutamol) was delivered through the mesh nebulizer-holding chamber and an mesh nebulizer-T-piece using normal tidal breathing. The subjects provided urine samples 30 min after dosing and cumulatively collected their urine for 24 h. The samples were analyzed for salbutamol content.
RESULTS
The holding chamber significantly increased aerosol emitted by the 3 nebulizers compared with the T-piece ( < .01) and relatively decreased the mass median aerodynamic diameter but with no significant difference. The mesh nebulizer-holding chamber resulted in significantly higher aerosol emitted compared with any other delivery method tested ( < .01). The mesh nebulizer-holding chamber resulted in higher urine samples 30 min after dosing (as an index of lung deposition) and cumulatively collected urine for 24 h (as an index of systemic absorption) compared with the nebulizer-T-piece ( < .05).
CONCLUSIONS
The use of the holding chamber with a jet nebulizer, Pro nebulizer, and the Solo nebulizer significantly increased the aerosol delivery. The Solo nebulizer-holding chamber had the highest aerosol emitted compared with all nebulizer-adapter combinations and higher urine samples 30 min after dosing and cumulatively collected urine for 24 h compared with the nebulizer-T-piece.
Topics: Administration, Inhalation; Adult; Aerosols; Albuterol; Bronchodilator Agents; Drug Delivery Systems; Equipment Design; Female; Forced Expiratory Volume; Healthy Volunteers; Humans; Inhalation Spacers; Male; Nebulizers and Vaporizers; Tidal Volume
PubMed: 29789412
DOI: 10.4187/respcare.06061 -
Archives of Disease in Childhood Nov 2001
Review
Topics: Albuterol; Asthma; Bronchodilator Agents; Child; Drug Therapy, Combination; Female; Humans; Ipratropium
PubMed: 12035817
DOI: No ID Found -
BMJ Case Reports Sep 2010A 7-year-old known asthmatic presented with an acute severe asthma attack to the Accident and Emergency department. Following a poor response to salbutamol and...
A 7-year-old known asthmatic presented with an acute severe asthma attack to the Accident and Emergency department. Following a poor response to salbutamol and ipratropium nebulisers, he was given intravenous salbutamol and aminophylline. Over the course of the following 3 h, there was improvement in his bronchospasm with decreasing oxygen requirement, however, his respiratory rate showed an upward trend. Serial blood gas estimations showed a worsening metabolic acidosis unresponsive to two fluid boluses of 20 ml/kg of normal saline. Lactate levels were subsequently measured and found to be high, accounting for the metabolic acidosis. High lactate levels were attributed to intravenous salbutamol. His blood gases and lactate level returned to normal within 3 h after stopping intravenous salbutamol. He was recommended on salbutamol nebulisers while still continuing on intravenous aminophylline. He continued to improve and was discharged home after 4 days.
Topics: Acidosis, Lactic; Albuterol; Blood Gas Analysis; Bronchodilator Agents; Child; Emergency Service, Hospital; Humans; Male; Status Asthmaticus
PubMed: 22778368
DOI: 10.1136/bcr.01.2010.2665 -
Journal of Food and Drug Analysis Apr 2018A liquid chromatography tandem mass spectrometric method was developed for the determination of two β-agonists (ractopamine and salbutamol) in pig hair samples. An...
A liquid chromatography tandem mass spectrometric method was developed for the determination of two β-agonists (ractopamine and salbutamol) in pig hair samples. An isotope of ractopamine-d5 or salbutamol-d6 as an internal standard was used to carry out quantitative analysis. Concentrated sodium hydroxide was used to pretreat hair samples and then purified by the solid phase extraction (SPE) procedure. The extracted solution was evaporated and reconstituted for injection in the instrument with electrospray ionization (ESI) operating in a positive multiple-reaction-monitoring (MRM) mode. Ractopamine and salbutamol separation were performed on C18 analytical column under gradient condition. The internal standard calibration curve was linear in the range of concentration from 0.5 to 100 ng mL (R > 0.995). Recoveries of this method estimated at three spiked concentrations of 100, 250 and 500 ng mL in pig hair samples, were 79-82% for ractopamine and 77-96% for salbutamol. The corresponding inter-day and intra-day precisions expressed as relative standard deviation (RSD %) were 3.8-6.4% and 3.8-8.6%, respectively. The analytical time for one sample was 8 min. The detection limit of this method was 0.6 and 8.3 ng mL for ractopamine and salbutamol, respectively. This developed method can be applied for monitoring the use of the β-agonists salbutamol and ractopamine in swine feed incurred pig hair.
Topics: Adrenergic beta-Agonists; Albuterol; Animals; Chromatography, High Pressure Liquid; Hair; Limit of Detection; Phenethylamines; Solid Phase Extraction; Swine; Tandem Mass Spectrometry
PubMed: 29567243
DOI: 10.1016/j.jfda.2017.09.005 -
British Medical Journal Sep 1977
Topics: Adult; Albuterol; Diabetic Ketoacidosis; Female; Humans; Infusions, Parenteral; Pregnancy; Pregnancy in Diabetics
PubMed: 410474
DOI: 10.1136/bmj.2.6089.768-b -
British Medical Journal Aug 1977
Topics: Adult; Albuterol; Diabetic Ketoacidosis; Female; Humans; Pregnancy; Pregnancy in Diabetics
PubMed: 407966
DOI: 10.1136/bmj.2.6084.438 -
Sultan Qaboos University Medical Journal Feb 2023Cutaneous larva migrans (CLM) is a zoonotic skin disease that is frequently diagnosed in tropical and subtropical countries. Loeffler's syndrome (LS) is a transient... (Review)
Review
Cutaneous larva migrans (CLM) is a zoonotic skin disease that is frequently diagnosed in tropical and subtropical countries. Loeffler's syndrome (LS) is a transient respiratory ailment characterised by pulmonary infiltration along with peripheral eosinophilia and commonly follows parasitic infestation. We report a 33-year-old male patient who presented to a tertiary care hospital in eastern India in 2019 with LS that was attributed secondary to multifocal CLM. Treatment with seven-day course of oral albendazole (400 mg daily) coupled with nebulisation (levosalbutamol and budesonide) led to complete resolution of cutaneous lesions and respiratory complaints within two weeks. There was complete resolution of pulmonary pathology at four-weeks follow-up.
Topics: Male; Humans; Adult; Larva Migrans; Skin; Albendazole; India; Levalbuterol
PubMed: 36865421
DOI: 10.18295/squmj.5.2022.036