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 (2) Methods: Portions of admixtures were withdrawn at certain time intervals after mixing and were tested by pH determination, osmolarity measurement, and high-performance liquid chromatography (HPLC) assay of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.

Use of spacers for patients treated with pressurized metered dose inhalers: focus on the VENTOLIN™ Mini Spacer.

INTRODUCTION: Spacers offer a multitude of benefits by reducing the requirement to coordinate inhalation with actuation and improving inhaler technique in patients using a pressurized metered dose inhaler (pMDI). Spacers improve drug targeting by retaining within the spacer large particles normally deposited in the oropharynx, and by creating a prolonged aerosol cloud of fine particles to give the user increased time to inhale after actuation. This is particularly important in young children and the elderly to effectively deliver medication to the airways. AREAS COVERED: By investigating the history and features of spacers, we demonstrate that the advantages of using spacers far outweigh their limitations. We also discuss the optimal characteristics of spacers in terms of shape, volume, presence of valve and static charge, and present a detailed discussion of the VENTOLIN™ Mini Spacer. EXPERT OPINION: Generally, the shape and size of spacers makes them inherently inconvenient. Consideration of human factors and modern design may make them more attractive to patients. However, the incentive to use spacers should be their ability to help patients correctly use inhaled medications delivered by pMDIs. Understanding of these principles through education is key to their acceptance by patients.

Effect of ventolin combined with pulmicort in the treatment of children with asthma and its influence on inflammatory cytokines / 中国基层医药

Objective To study the effect of ventolin combined with pulmicort in the treatment of children with asthma and its influence on inflammatory cytokines .Methods 100 children with asthma were randomly divided into observation group(50 cases) and control group(50 cases) according to the digital table.The control group was given pulmicort treatment ,the observation group was given 0.5％ ventolin combined with pulmicort .The course of treatment was 3-5 days.The remission time,the levels of inflammatory cytokines (IL-17 and TGF ) and adverse reactions were compared between the two groups .Results After treatment,the VC,FVC and PEFC of the observation group were significantly better than those of the control group ,the differences were statistically significant (t=2.412, 9.806,3.922,all P<0.05).The remission time of clinical symptoms of the observation group was better than those of the control group(t=5.182,4.576,4.166,5.761,all P<0.05 ).There was no statistically significant difference in the side effects between the two groups (18.00％vs.16.00％,χ2 =2.153,P>0.05).The levels of IL-6 and TGF in the observation group were lower than those in the control group (t =8.234,25.075,all P <0.05). Conclusion Ventolin combined with pulmicort in the treatment of children with asthma can effectively relieve clinical symptoms,reduce the inflammatory cytokines ,improve pulmonary function ,so it is worthy of further clinical application .

Efficacy and security of triple aerosol inhalation of pulmicort respules,ventolin and ipratropine in treatment of severe acute asthma exacerbations / 中国基层医药

Objective To investigate the clinical efficacy and safety of intravenous inhalation of pumicillin,ventolin and ipratropine in the treatment of severe acute asthma exacerbations in adults.Methods 78 adult patients with severe asthma were randomly divided into research group and control group by the method of random number table.The patients in the control group received routine treatment,it was intravenous infusion of methylprednisolone.On the basis of the above, the research group received intravenous inhalation of pumicil.The clinical efficacy,methylprednisolone use and use of time,asthma symptoms score,the disappearance of asthma symptoms and the incidence of adverse reactions of the two groups were observed and compared.Results The effective rate of the research group was 97.44% (38/39),which was higher than 82.05% (32/39) of the control group (x2=5.014,P0.05).Conclusion On the basis of intravenous medication,combined with pumicillin,ventolin and ipratropine triple inhalation in the treatment of severe asthma patients,can reduce the intravenous use of methylprednisolone,it was effective in patients with asthma symptoms,the clinical efficacy is significant,the clinical value is higher,it is worthy of promotion and application.

Effect of Hanchuan Zupa granule combined withventolin atomizing inhalation in infantile bronchial asthma and the influence of serum MPO, PMN, MCP-4 / 中国生化药物杂志

Objective To investigate thecurative effect of Hanchuan Zupa granule combined with ventolin atomizing inhalation in the treatment of infantile bronchial asthma and the influence of serum myeloperoxidase(MPO),neutrophil(PMN),monocyte chemotactic protein-4(MCP-4).Methods 92 cases of infantile bronchial asthma from June 2015 to June 2016 in yiwu materal and child health care family planning senice center,according to the draw method was divided into the control group(n=46)and experimental group(n=46),the control group was treated with salbutamol inhalation,and the experimental group was based on control group treated with Hanchuan Zupa granule,the curative effect,MPO,PMN,MCP-4,inflammatory factor,the T lymphocyte subgroup,arterial blood gas index,clinical symptoms disappeared time and safety of two groups were observed.Results After treatmented,the total effective rate of experimental group was 93.48％higher than that of control group 76.08％,the difference was statistically significant(P<0.05).The MPO,PMN,MCP-4 of experimental group was lower than the control group,the difference was statistically significant(P<0.05).The inflammatory factor,T lymphocyte subgroup,arterial blood gas index in the experimental group were more significantly improved than those in the control group,the difference was statistically significant(P<0.05).The clinical symptoms disappear time of experimental group was better than that of control group,the difference was statistically significant(P<0.05).There was no significant difference in safety between the two groups.Conclusion Hanchuan Zupa granule combined withventolin atomizing inhalation of children with bronchial asthma in the exact effect,and down-regulated the expression of MPO,PMN,MCP-4,promote the recovery of children.

Effect of Ventolin on QTc in children with respiratory distress.

INTRODUCTION: ß2-agonists are first election drugs for the treatment of respiratory disease that may alter cardiac autonomic modulation. The aim of this study was to evaluate the effects of nebulized Ventolin on electrocardiogram, particularly QTc interval to assess the potential arrhythmogenic risks. METHODS: A total of 192 patients between 2 months and 15 years which received nebulized Ventolin were enrolled in this study. Patients were divided into two groups. Electrocardiograms of patients before and after nebulized Ventolin were taken. Differences between two groups were assessed using a paired student's t test. RESULTS: There was statistically significant differences in QTc before and after Ventolin in each groups (P<0.005).Ventolin effect on QTc interval in both groups did not differ. In first group, there was statistically significant differences between heart rate before and after Ventolin taken (P=0.009) but in second group there was not statistically significant differences between heart rate (P=0.345). CONCLUSION: Although Ventolin can cause changes in QTc, Ventolin with 0.15 mg/kg/dose in comparison with 0.1 mg/kg/dose does not cause significant changes in QTc.

Therapeutic effects of Ventolin versus hypertonic saline 3% for acute bronchiolitis in children.

BACKGROUND: Complications of Ventolin as the most common drug used for bronchiolitis are widely known. The present study was conducted to determine the efficacy of hypertonic saline 3%, compared with Ventolin, for treatment of acute bronchiolitis in children. METHODS: This double-blinded clinical trial study was conducted in Hajar Hospital, Shahrekord, Iran, from 2011 to 2012. A total of 70 patients under the age of two years with bronchiolitis were divided into two groups of 35 each. Ventolin nebulizer and hypertonic saline 3% nebulizer three times per day were administered in the first (Ventolin) and second (Hypersaline) group, respectively. The length of recovery was compared between the two groups. The data were analyzed by SPSS software (version 22) using chi-square, t-test, paired t-test, and Mann-Whitney. RESULTS: The mean±SD length of recovery was 4.14±0.9 and 3.06±0.6 in the Ventolin and hypersaline groups, respectively. The mean duration of recovery was significantly lower in the hypersaline group (p<0.001). CONCLUSION: Hypertonic saline 3% nebulizer has more pleasant therapeutic effects on acute bronchiolitis than Ventolin. Therefore, use of hypertonic saline 3% nebulizer is recommended for the treatment of acute bronchiolitis in children under two years old.

Performance of pressurized metered-dose inhalers at extreme temperature conditions.

The performance of pressurized metered-dose inhalers (pMDIs) under a variety of temperature conditions was investigated. The effects of both inhaler temperature and ambient temperature were considered. The inhaler temperature ranged from -13.0°C to 41.7°C and the ambient temperature ranged from -12.0°C to 41.7°C. The in vitro lung dose was measured for four widely available pMDIs: Airomir(TM) , QVAR(TM) , Symbicort(®) , and Ventolin(®) . The in vitro lung dose through an Alberta Idealized Throat was measured by gravimetric assay, which was verified by UV spectroscopic assay. A decrease in the in vitro lung dose was observed for all evaluated pMDIs when ambient temperature and device temperature were simultaneously reduced, decreasing on average by 70% at the coldest temperatures, whereas increasing on average by 25% at the elevated temperature condition. In vitro lung dose is strongly dependent on both inhaler temperature and ambient temperature with the tested pMDIs.

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.