Compatible Stability and Aerosol Characteristics of Atrovent® (Ipratropium Bromide) Mixed with Salbutamol Sulfate, Terbutaline Sulfate, Budesonide, and Acetylcysteine.

(1) Background: It is common practice in the treatment of respiratory diseases to mix different inhalation solutions for simultaneous inhalation. At present, a small number of studies have been published that evaluate the physicochemical compatibility and aerosol characteristics of different inhalation medications. However, none of them studied Atrovent®. Our work aims to address the lack of studies on Atrovent®. (2) Methods: Portions of admixtures were withdrawn at certain time intervals after mixing and were tested by pH determination, osmolarity measurement, and high-performance liquid chromatography (HPLC) assay of each active ingredient as measures of physicochemical compatibility. The geometrical and aerosol particle size distribution, active drug delivery rate, and total active drug delivered were measured to characterize aerosol behaviors. (3) Results: During the testing time, no significant variation was found in the pH value, the osmotic pressure, or the active components of admixtures. With the increase in nebulization volume after mixing, fine particle dose (FPD) and total active drug delivered showed statistically significant improvements, while the active drug delivery rate decreased compared to the single-drug preparations. (4) Conclusions: These results endorse the physicochemical compatibility of Atrovent® over 1 h when mixed with other inhalation medications. Considering aerosol characteristics, simultaneous inhalation is more efficient.

Safety of Atrovent® CFC-free inhaler: respiratory events reported from an observational cohort study in England.

OBJECTIVES: The aim of the study was to identify any unexpected clinical events associated with starting the new CFC-free formulation of Atrovent® MDI in general practice in England. METHODS: An active surveillance cohort study was conducted with a focus on selected clinical events, including respiratory symptoms, in past users of Atrovent® CFC MDI ('switchers') and Atrovent® naïve users. Incidence density rate ratios (with 99% confidence intervals) for events occurring in the first 3 months of exposure (risk period-ID1-3 ) compared to 3 months prior to starting treatment (reference period-IDR ) were calculated. RESULTS: The cohort consisted of 13 211 patients (median age 70 years, 50.1% female; 63.5% prior users of Atrovent® CFC MDI ('switchers')). Common respiratory events occurred at higher rates after starting treatment than before for switchers, for example lower respiratory tract infection (LRTI) [ID1 /IDR = 1.45 (99% CI: 1.17, 1.81)] and worsening asthma [ID1 /IDR = 1.58 (99% CI: 1.00, 2.51)]. Of these events only LRTI was significant for Atrovent® naïve patients [ID1 /IDR = 1.42 (99% CI: 1.04, 1.95)]. CONCLUSIONS: The results of this study suggest effect modification of risk as a result of prior Atrovent® CFC MDI use. Overall, Atrovent® CFC-free MDI appeared to be reasonably well tolerated in the immediate postmarketing period and the safety profile appeared similar to that of the CFC formulation.

Treatment and intervention effect of Atrovent aerosol inhalation analysis in patients with chronic obstructive pulmonary disease respiratory failure / 中国生化药物杂志

Objective To investigate the effects of Atrovent aerosol inhalation in the treatment of respiratory failure and nursing intervention of chronic obstructive pulmonary disease effect. Methods January 2016 to December 2016 in Huzhou Central Hospital for diagnosis and treatment of chronic obstructive pulmonary disease patients with respiratory failure in 50 cases dewided into control group and observationgroup: the control group treated with conventional methods, the observation group treated with Atrovent aerosol inhalation therapy and conventional methods; the patients in the two groups of experimental data were recorded in detail, and the obtained data were analyzed. Results The observation group was better than that of treatment and intervention control group, clinical symptoms improved better than the control group, the adverse reaction rate were lower than the control group, there is significant statistical difference (P<0.05). Conclusion The patients with chronic obstructive pulmonary disease with respiratory failure choose conventional and Atrovent aerosol inhalation treatment effect significantly, can effectively improve the patient clinical symptoms and adverse reactions are few and deserve to be widely used in the treatment of chronic obstructive pulmonary diseaseand respiratory failure patients.

Efficacy of Fog Inhalation Therapy in Treating Acute Episode of Bronchial Asthma / 中国药房

OBJECTIVE:To evaluate the therapeutic efficacy of oxygen-driven aerosol inhalation of Ventolin plus Atrovent and Budesonide suspension for acute episode of intermediate or severe degree of bronchial asthma. METHODS:A total of 48 patients with bronchial asthma were divided into two groups randomly:26 cases in the treatment group received normal saline (1 mL) +Ventolin (2 mL) + Atrovent (2 mL) and Budesonide suspension(4 mL) q6 h in addition to the routinetherapy by high-flow oxygen driven in addition to the routine therapy; 22 cases in the control group received Ventolin inhaler(200 ?g) q 6 h. The improvement of clinical symptoms in the two groups after treatment for 3 days,the forced expiratory volume in one second (FEV1),forced vital capacity (FVC),peak expiratory flow (PEF) at 3 h and 5 days,respectively,the blood sugar level,arterial blood gas index as well as duration of systemic use of hormone and the hospital days were compared between two groups. RESULTS:After treatment for 3 days,the effective rate in the treatment group(24/26) was significantly higher than in the control group (14/22),showing significant differences between two groups. At 3 h,there were significant differences between the treatment group and the control group in FEV1 and PEF but not in FVC; at 5 days,there were significant differences between the treatment group and the control group in FEV1,FVC and PEF. On day 5,there were significant differences between two groups in PaO2,PaCO2 and blood sugar level as well as in the duration of systemic use of hormone and the hospital days. CONCLUSION:Aerosol inhalation of Ventolin plus Atrovent and Budesonide suspension shows remarkable therapeutic efficacy for acute episode of intermediate or severe degree of bronchial asthma.

Cost-Effectiveness Analysis of Two Drug Combination Schemes for Acute Episode of Chronic Obstructive Pulmonary Disease / 中国药房

0.05),respectively and the cost-effectiveness ratios were 689 and 1 202 respectively.CONCLUSION:The treatment group was superior to as compared with the control group.