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[PMID]:28703592
[Au] Autor:Yan S; Shaw DE; Yang L; Sandham DA; Healy MP; Reilly J; Wang B
[Ad] Endereço:Global Discovery Chemistry, Novartis Institutes for BioMedical Research , Cambridge, Massachusetts 02139, United States.
[Ti] Título:Interactions between ß2-Adrenoceptor Ligands and Membrane: Atomic-Level Insights from Magic-Angle Spinning NMR.
[So] Source:J Med Chem;60(16):6867-6879, 2017 Aug 24.
[Is] ISSN:1520-4804
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:To understand the relationship between structural properties of the ß2-adrenoceptor ligands and their interactions with membranes, we have investigated the location and distribution of five ß2 agonists with distinct clinical durations and onsets of action (indacaterol, two indacaterol analogues, salmeterol and formoterol) in monounsaturated model membranes using magic angle spinning NMR to measure these interactions through both H nuclear Overhauser enhancement (NOE) and paramagnetic relaxation enhancement (PRE) techniques. The hydrophilic aromatic groups of all five ß2 agonists show maximum distribution in the lipid/water interface, but distinct location and dynamic behavior were observed for the lipophilic aromatic rings. Our study elucidates at atomic level that the hydrophobicity and substitution geometry of lipophilic groups play important roles in compound-lipid interactions.
[Mh] Termos MeSH primário: Agonistas de Receptores Adrenérgicos beta 2/química
Lipossomos/química
[Mh] Termos MeSH secundário: Fumarato de Formoterol/química
Interações Hidrofóbicas e Hidrofílicas
Indanos/química
Ligantes
Espectroscopia de Ressonância Magnética
Fosfatidilcolinas/química
Quinolonas/química
Xinafoato de Salmeterol/química
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Adrenergic beta-2 Receptor Agonists); 0 (Indans); 0 (Ligands); 0 (Liposomes); 0 (Phosphatidylcholines); 0 (Quinolones); 6EW8Q962A5 (Salmeterol Xinafoate); 8OR09251MQ (indacaterol); TE895536Y5 (1-palmitoyl-2-oleoylphosphatidylcholine); W34SHF8J2K (Formoterol Fumarate)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170714
[St] Status:MEDLINE
[do] DOI:10.1021/acs.jmedchem.7b00205


  2 / 1729 MEDLINE  
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[PMID]:28292484
[Au] Autor:Hoogendoorn M; Feenstra TL; Asukai Y; Briggs AH; Hansen RN; Leidl R; Risebrough N; Samyshkin Y; Wacker M; Rutten-van Mölken MP
[Ad] Endereço:Institute for Medical Technology Assessment (iMTA), Erasmus University Rotterdam, Rotterdam, The Netherlands. Electronic address: hoogendoorn@imta.eur.nl.
[Ti] Título:External Validation of Health Economic Decision Models for Chronic Obstructive Pulmonary Disease (COPD): Report of the Third COPD Modeling Meeting.
[So] Source:Value Health;20(3):397-403, 2017 Mar.
[Is] ISSN:1524-4733
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To validate outcomes of presently available chronic obstructive pulmonary disease (COPD) cost-effectiveness models against results of two large COPD trials-the 3-year TOwards a Revolution in COPD Health (TORCH) trial and the 4-year Understanding Potential Long-term Impacts on Function with Tiotropium (UPLIFT) trial. METHODS: Participating COPD modeling groups simulated the outcomes for the placebo-treated groups of the TORCH and UPLIFT trials using baseline characteristics of the trial populations as input. Groups then simulated treatment effectiveness by using relative reductions in annual decline in lung function and exacerbation frequency observed in the most intensively treated group compared with placebo as input for the models. Main outcomes were (change in) total/severe exacerbations and mortality. Furthermore, the absolute differences in total exacerbations and quality-adjusted life-years (QALYs) were used to approximate the cost per exacerbation avoided and the cost per QALY gained. RESULT: Of the six participating models, three models reported higher total exacerbation rates than observed in the TORCH trial (1.13/patient-year) (models: 1.22-1.48). Four models reported higher rates than observed in the UPLIFT trial (0.85/patient-year) (models: 1.13-1.52). Two models reported higher mortality rates than in the TORCH trial (15.2%) (models: 20.0% and 30.6%) and the UPLIFT trial (16.3%) (models: 24.8% and 36.0%), whereas one model reported lower rates (9.8% and 12.1%, respectively). Simulation of treatment effectiveness showed that the absolute reduction in total exacerbations, the gain in QALYs, and the cost-effectiveness ratios did not differ from the trials, except for one model. CONCLUSIONS: Although most of the participating COPD cost-effectiveness models reported higher total exacerbation rates than observed in the trials, estimates of the absolute treatment effect and cost-effectiveness ratios do not seem different from the trials in most models.
[Mh] Termos MeSH primário: Broncodilatadores/economia
Análise Custo-Benefício/métodos
Análise Custo-Benefício/normas
Fluticasona/economia
Doença Pulmonar Obstrutiva Crônica/economia
Xinafoato de Salmeterol/economia
Brometo de Tiotrópio/economia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Broncodilatadores/uso terapêutico
Simulação por Computador
Tomada de Decisões
Economia Médica
Feminino
Fluticasona/uso terapêutico
Seres Humanos
Masculino
Meia-Idade
Modelos Econométricos
Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico
Doença Pulmonar Obstrutiva Crônica/mortalidade
Anos de Vida Ajustados por Qualidade de Vida
Ensaios Clínicos Controlados Aleatórios como Assunto
Xinafoato de Salmeterol/uso terapêutico
Brometo de Tiotrópio/uso terapêutico
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Nm] Nome de substância:
0 (Bronchodilator Agents); 6EW8Q962A5 (Salmeterol Xinafoate); CUT2W21N7U (Fluticasone); XX112XZP0J (Tiotropium Bromide)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170605
[Lr] Data última revisão:
170605
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170316
[St] Status:MEDLINE


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[PMID]:28159683
[Au] Autor:Davidson N; Tong HJ; Kalberer M; Seville PC; Ward AD; Kuimova MK; Pope FD
[Ad] Endereço:School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
[Ti] Título:Measurement of the Raman spectra and hygroscopicity of four pharmaceutical aerosols as they travel from pressurised metered dose inhalers (pMDI) to a model lung.
[So] Source:Int J Pharm;520(1-2):59-69, 2017 Mar 30.
[Is] ISSN:1873-3476
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Particle inhalation is an effective and rapid delivery method for a variety of pharmaceuticals, particularly bronchodilation drugs used for treating asthma and COPD. Conditions of relative humidity and temperature inside the lungs are generally very different from the outside ambient air, with the lung typically being warmer and more humid. Changes in humidity, from inhaler to lung, can cause hygroscopic phase transitions and particle growth. Increasing particle size and mass can negatively affect particle deposition within the lung leading to inefficient treatment, while deliquescence prior to impaction is liable to accelerate drug uptake. To better understand the hygroscopic properties of four pharmaceutical aerosol particles; pharmaceutical particles from four commercially available pressurised metered dose inhalers (pMDIs) were stably captured in an optical trap, and their composition was examined online via Raman spectroscopy. Micron-sized particles of salbutamol sulfate, salmeterol xinafoate, fluticasone propionate and ciclesonide were levitated and examined over a range of relative humidity values inside a chamber designed to mimic conditions within the respiratory tract. The effect of temperature upon hygroscopicity was also investigated for salbutamol sulfate particles. Salbutamol sulfate was found to have significant hygroscopicity, salmeterol xinafoate showed some hygroscopic interactions, whilst fluticasone propionate and ciclesonide revealed no observable hygroscopicity. Thermodynamic and structural modelling is used to explain the observed experimental results.
[Mh] Termos MeSH primário: Aerossóis/química
Análise Espectral Raman
Molhabilidade
[Mh] Termos MeSH secundário: Albuterol/química
Fluticasona/química
Umidade
Inaladores Dosimetrados
Modelos Estruturais
Tamanho da Partícula
Pregnenodionas/química
Xinafoato de Salmeterol/química
Temperatura Ambiente
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Aerosols); 0 (Pregnenediones); 6EW8Q962A5 (Salmeterol Xinafoate); CUT2W21N7U (Fluticasone); QF8SVZ843E (Albuterol); S59502J185 (ciclesonide)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171009
[Lr] Data última revisão:
171009
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170205
[St] Status:MEDLINE


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[PMID]:27887950
[Au] Autor:Sekioka T; Kadode M; Yonetomi Y; Kamiya A; Fujita M; Nabe T; Kawabata K
[Ad] Endereço:Minase Research Institute, Ono Pharmaceutical Co., Ltd, Osaka, Japan. Electronic address: sekioka@ono.co.jp.
[Ti] Título:CysLT receptor activation is involved in LTC -induced lung air-trapping in guinea pigs.
[So] Source:Eur J Pharmacol;794:147-153, 2017 Jan 05.
[Is] ISSN:1879-0712
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:CysLT receptors are known to be involved in the pathogenesis of asthma. However, the functional roles of CysLT receptors in this condition have not been determined. The purpose of this study is to develop an experimental model of CysLT receptor-mediated LTC -induced lung air-trapping in guinea pigs and use this model to clarify the mechanism underlying response to such trapping. Because LTC is rapidly converted to LTD by γ-glutamyltranspeptidase (γ-GTP) under physiological conditions, S-hexyl GSH was used as a γ-GTP inhibitor. In anesthetized artificially ventilated guinea pigs with no S-hexyl GSH treatment, i.v. LTC -induced bronchoconstriction was almost completely inhibited by montelukast, a CysLT receptor antagonist, but not by BayCysLT RA, a CysLT receptor antagonist. The inhibitory effect of montelukast was diminished by treatment with S-hexyl GSH, whereas the effect of BayCysLT RA was enhanced with increasing dose of S-hexyl GSH. Macroscopic and histological examination of lung tissue isolated from LTC -/S-hexyl-GSH-treated guinea pigs revealed air-trapping expansion, particularly at the alveolar site. Inhaled LTC in conscious guinea pigs treated with S-hexyl GSH increased both airway resistance and airway hyperinflation. On the other hand, LTC -induced air-trapping was only partially suppressed by treatment with the bronchodilator salmeterol. Although montelukast inhibition of LTC -induced air-trapping was weak, treatment with BayCysLT RA resulted in complete suppression of this air-trapping. Furthermore, BayCysLT RA completely suppressed LTC -induced airway vascular hyperpermeability. In conclusion, we found in this study that CysLT receptors mediate LTC -induced bronchoconstriction and air-trapping in S-hexyl GSH-treated guinea pigs. It is therefore believed that CysLT receptors contribute to asthmatic response involving air-trapping.
[Mh] Termos MeSH primário: Ar
Leucotrieno C4/farmacologia
Pulmão/efeitos dos fármacos
Pulmão/fisiologia
Receptores de Leucotrienos/metabolismo
[Mh] Termos MeSH secundário: Animais
Broncoconstrição/efeitos dos fármacos
Ácidos Cicloexanocarboxílicos/farmacologia
Glutationa/análogos & derivados
Glutationa/farmacologia
Cobaias
Pulmão/metabolismo
Masculino
Ácidos Ftálicos/farmacologia
Respiração Artificial
Xinafoato de Salmeterol/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (3-(((3-carboxycyclohexyl)amino)carbonyl)-4-(3-(4-(4-phenoxybutoxy)phenyl)propoxy)benzoic acid); 0 (Cyclohexanecarboxylic Acids); 0 (Phthalic Acids); 0 (Receptors, Leukotriene); 0 (cysteinyl leukotriene receptor 2); 2CU6TT9V48 (Leukotriene C4); 6EW8Q962A5 (Salmeterol Xinafoate); GAN16C9B8O (Glutathione); M73SNN908F (hexylglutathione)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170405
[Lr] Data última revisão:
170405
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161127
[St] Status:MEDLINE


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[PMID]:27879340
[Au] Autor:Tsvetanova NG; Trester-Zedlitz M; Newton BW; Riordan DP; Sundaram AB; Johnson JR; Krogan NJ; von Zastrow M
[Ad] Endereço:Department of Psychiatry (N.G.T., M.T.-Z., M.Z.), Department of Cellular and Molecular Pharmacology (M.Z.), California Institute for Quantitative Biosciences (B.W.N., J.R.J., N.J.K.), and Lung Biology Center, Department of Medicine (A.B.S.), University of California, San Francisco, San Francisco, Ca
[Ti] Título:G Protein-Coupled Receptor Endocytosis Confers Uniformity in Responses to Chemically Distinct Ligands.
[So] Source:Mol Pharmacol;91(2):145-156, 2017 Feb.
[Is] ISSN:1521-0111
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The ability of chemically distinct ligands to produce different effects on the same G protein-coupled receptor (GPCR) has interesting therapeutic implications, but, if excessively propagated downstream, would introduce biologic noise compromising cognate ligand detection. We asked whether cells have the ability to limit the degree to which chemical diversity imposed at the ligand-GPCR interface is propagated to the downstream signal. We carried out an unbiased analysis of the integrated cellular response elicited by two chemically and pharmacodynamically diverse ß-adrenoceptor agonists, isoproterenol and salmeterol. We show that both ligands generate an identical integrated response, and that this stereotyped output requires endocytosis. We further demonstrate that the endosomal ß2-adrenergic receptor signal confers uniformity on the downstream response because it is highly sensitive and saturable. Based on these findings, we propose that GPCR signaling from endosomes functions as a biologic noise filter to enhance reliability of cognate ligand detection.
[Mh] Termos MeSH primário: Endocitose
Receptores Acoplados a Proteínas-G/metabolismo
[Mh] Termos MeSH secundário: Endossomos/efeitos dos fármacos
Endossomos/metabolismo
Células HEK293
Seres Humanos
Isoproterenol/farmacologia
Ligantes
Espectrometria de Massas
Modelos Biológicos
Análise de Sequência com Séries de Oligonucleotídeos
Fosfoproteínas/metabolismo
Fosforilação/efeitos dos fármacos
Proteoma/metabolismo
Proteômica
Receptores Adrenérgicos beta 2/metabolismo
Xinafoato de Salmeterol/farmacologia
Transdução de Sinais/efeitos dos fármacos
Transcrição Genética/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Ligands); 0 (Phosphoproteins); 0 (Proteome); 0 (Receptors, Adrenergic, beta-2); 0 (Receptors, G-Protein-Coupled); 6EW8Q962A5 (Salmeterol Xinafoate); L628TT009W (Isoproterenol)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170509
[Lr] Data última revisão:
170509
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161124
[St] Status:MEDLINE
[do] DOI:10.1124/mol.116.106369


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[PMID]:27814453
[Au] Autor:Kaminsky DA; Wang LL; Bates JH; Thamrin C; Shade DM; Dixon AE; Wise RA; Peters S; Irvin CG
[Ad] Endereço:1 Pulmonary and Critical Care, University of Vermont College of Medicine, Burlington, Vermont.
[Ti] Título:Fluctuation Analysis of Peak Expiratory Flow and Its Association with Treatment Failure in Asthma.
[So] Source:Am J Respir Crit Care Med;195(8):993-999, 2017 Apr 15.
[Is] ISSN:1535-4970
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Temporal fluctuations have been demonstrated in lung function and asthma control, but the effect of controller therapy on these fluctuations is unknown. OBJECTIVES: To determine if fluctuations in peak expiratory flow (PEF) are predictive of subsequent treatment failure and may be modified by controller therapy. METHODS: We applied detrended fluctuation analysis to once-daily PEF data from 493 participants in the LOCCS (Leukotriene Modifier Corticosteroid or Corticosteroid-Salmeterol) trial of the American Lung Association Airways Clinical Research Centers. We evaluated the coefficient of variation of PEF (CVpef) and the scaling exponent α, reflecting self-similarity of PEF, in relation to treatment failure from the run-in period of open-label inhaled fluticasone, and the treatment periods for subjects randomized to (1) continued twice daily fluticasone (F), (2) once daily fluticasone plus salmeterol (F + S), or (3) once daily oral montelukast (M). MEASUREMENTS AND MAIN RESULTS: The CVpef was higher in those with treatment failure in the F and F + S groups in the run-in phase, and all three groups in the treatment phase. α was similar between those with and without treatment failure in all three groups during the run-in phase but was higher among those with treatment failure in the F and F + S groups during the treatment phase. Participants in all three groups showed variable patterns of change in α leading up to treatment failure. CONCLUSIONS: We conclude that increased temporal self-similarity (α) of more variable lung function (CVpef) is associated with treatment failure, but the pattern of change in self-similarity leading up to treatment failure is variable across individuals.
[Mh] Termos MeSH primário: Acetatos/farmacologia
Antiasmáticos/farmacologia
Asma/tratamento farmacológico
Broncodilatadores/farmacologia
Fluticasona/farmacologia
Quinolinas/farmacologia
Xinafoato de Salmeterol/farmacologia
[Mh] Termos MeSH secundário: Administração por Inalação
Adulto
Quimioterapia Combinada
Feminino
Seres Humanos
Masculino
Pico do Fluxo Expiratório/efeitos dos fármacos
Falha de Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Acetates); 0 (Anti-Asthmatic Agents); 0 (Bronchodilator Agents); 0 (Quinolines); 6EW8Q962A5 (Salmeterol Xinafoate); CUT2W21N7U (Fluticasone); MHM278SD3E (montelukast)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170503
[Lr] Data última revisão:
170503
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161105
[St] Status:MEDLINE
[do] DOI:10.1164/rccm.201601-0076OC


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[PMID]:27718262
[Au] Autor:Inoue H; Niimi A; Matsumoto H; Ito I; Oguma T; Otsuka K; Takeda T; Nakaji H; Tajiri T; Iwata T; Nagasaki T; Mishima M
[Ad] Endereço:Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
[Ti] Título:A 12-week, randomized, parallel-group, proof-of-concept study of tulobuterol patch and salmeterol inhaler as add-on therapy in adult-onset mild-to-moderate asthma.
[So] Source:Clin Exp Pharmacol Physiol;44(1):21-29, 2017 Jan.
[Is] ISSN:1440-1681
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:Patch formulation of tulobuterol has been used in asthma treatment as a long-acting ß -agonist (LABA) through sustained skin absorption. Its treatment efficacy, especially in small airways, remains poorly understood. The study aim was to investigate LABA add-on effects of tulobuterol patch (TP) and salmeterol inhaler (SA) on pulmonary function, asthma control and health status. Patients who had adult-onset under-control asthma, despite taking inhaled corticosteroids, were enrolled in a randomized, open-label, parallel-group, proof-of-concept study of 12-week add-on treatment with TP (n=16) or SA (n=17). Spirometry, impulse oscillometry (IOS), exhaled nitric oxide levels, and clinical questionnaires of asthma control, health status (St. George's Respiratory Questionnaire: SGRQ), and symptoms were evaluated every 4 weeks. Add-on treatment of SA significantly improved the spirometric indices of small airway obstruction (forced expiratory flow between 25% and 75% of FVC: FEF , and maximum expiratory flow at 25% of FVC: MEF ) and IOS indices of whole respiratory resistance (resistance at 5 Hz) as compared to TP. In intra-group comparisons, add-on treatment of TP improved the scores of the asthma control test and the total SGRQ, as well as the symptom and impact components of the SGRQ. SA add-on treatment improved FEV and IOS parameters of resistance at 20 Hz and reactance at 5 Hz. Neither of the treatments improved exhaled nitric oxide levels. In conclusion, add-on treatment of TP improved asthma control and health status, whereas SA improved pulmonary function measures associated with large and small airway involvement among patients with adult-onset mild-to-moderate asthma.
[Mh] Termos MeSH primário: Asma/tratamento farmacológico
Broncodilatadores/administração & dosagem
Nebulizadores e Vaporizadores
Xinafoato de Salmeterol/administração & dosagem
Terbutalina/análogos & derivados
Adesivo Transdérmico
[Mh] Termos MeSH secundário: Adulto
Idoso
Asma/diagnóstico
Asma/fisiopatologia
Quimioterapia Combinada
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Espirometria/métodos
Terbutalina/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Bronchodilator Agents); 591I9SU0F7 (tulobuterol); 6EW8Q962A5 (Salmeterol Xinafoate); N8ONU3L3PG (Terbutaline)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161009
[St] Status:MEDLINE
[do] DOI:10.1111/1440-1681.12683


  8 / 1729 MEDLINE  
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[PMID]:27515731
[Au] Autor:Kersten ET; Koppelman GH; Thio BJ
[Ad] Endereço:University of Groningen, University Medical Center Groningen, Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, GRIAC research institute, PO Box 30.001, 9700 RB Groningen, The Netherlands. Electronic address: e.t.g.kersten@umcg.nl.
[Ti] Título:Concerns with beta2-agonists in pediatric asthma - a clinical perspective.
[So] Source:Paediatr Respir Rev;21:80-85, 2017 Jan.
[Is] ISSN:1526-0550
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Beta2-adrenoreceptor agonists (ß2-agonists) are extensively used in the treatment of childhood asthma. However, there have been concerns regarding their adverse effects and safety. In 2005, the FDA commissioned a "Black Box Warning" communicating the potential for an increased risk for serious asthma exacerbations or asthma related deaths, with the regular use of LABAs. In a meta-analysis of controlled clinical trials, the incidence of severe adverse events appeared to be highest in the 4-11 year age group. Several mechanisms have been proposed regarding the risk of regular use of ß2-agonists, such as masking patients' perception of worsening asthma, desensitization and downregulation of the ß2-adrenoreceptor, pro-inflammatory effects of ß2-agonists, pharmacogenetic effects of ß2-adrenoreceptor polymorphisms and age related differences in pathophysiology of asthma. In this paper, we review ß2-receptor pharmacology, discuss the concerns regarding treatment with ß2-agonists in childhood asthma, and provide suggestions for clinical pediatric practice in the light of current literature.
[Mh] Termos MeSH primário: Agonistas de Receptores Adrenérgicos beta 2/efeitos adversos
Asma/tratamento farmacológico
Hospitalização/estatística & dados numéricos
Intubação Intratraqueal/utilização
[Mh] Termos MeSH secundário: Asma/mortalidade
Criança
Pré-Escolar
Regulação para Baixo
Rotulagem de Medicamentos
Seres Humanos
Mortalidade
Variantes Farmacogenômicos
Receptores Adrenérgicos beta 2/genética
Xinafoato de Salmeterol/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Adrenergic beta-2 Receptor Agonists); 0 (Receptors, Adrenergic, beta-2); 6EW8Q962A5 (Salmeterol Xinafoate)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170921
[Lr] Data última revisão:
170921
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160813
[St] Status:MEDLINE


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[PMID]:27409253
[Au] Autor:Sulaiman I; Cushen B; Greene G; Seheult J; Seow D; Rawat F; MacHale E; Mokoka M; Moran CN; Sartini Bhreathnach A; MacHale P; Tappuni S; Deering B; Jackson M; McCarthy H; Mellon L; Doyle F; Boland F; Reilly RB; Costello RW
[Ad] Endereço:1 Clinical Research Centre, Beaumont Hospital.
[Ti] Título:Objective Assessment of Adherence to Inhalers by Patients with Chronic Obstructive Pulmonary Disease.
[So] Source:Am J Respir Crit Care Med;195(10):1333-1343, 2017 May 15.
[Is] ISSN:1535-4970
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Objective adherence to inhaled therapy by patients with chronic obstructive pulmonary disease (COPD) has not been reported. OBJECTIVES: To objectively quantify adherence to preventer Diskus inhaler therapy by patients with COPD with an electronic audio recording device (INCA). METHODS: This was a prospective observational study. On discharge from hospital patients were given a salmeterol/fluticasone inhaler with an INCA device attached. Analysis of this audio quantified the frequency and proficiency of inhaler use. MEASUREMENTS AND MAIN RESULTS: Patients with COPD (n = 244) were recruited. The mean age was 71 years, mean FEV was 1.3 L, and 59% had evidence of mild/moderate cognitive impairment. By combining time of use, interval between doses, and critical technique errors, thus incorporating both intentional and unintentional nonadherence, a measure "actual adherence" was calculated. Mean actual adherence was 22.6% of that expected if the doses were taken correctly and on time. Six percent had an actual adherence greater than 80%. Hierarchical clustering found three equally sized well-separated clusters corresponding to distinct patterns. Cluster 1 (34%) had low inhaler use and high error rates. Cluster 2 (25%) had high inhaler use and high error rates. Cluster 3 (36%) had overall good adherence. Poor lung function and comorbidities were predictive of poor technique, whereas age and cognition with poor lung function distinguished those with poor adherence and frequent errors in technique. CONCLUSIONS: These data may inform clinicians in understanding why a prescribed inhaler is not effective and to devise strategies to promote adherence in COPD.
[Mh] Termos MeSH primário: Broncodilatadores/administração & dosagem
Nebulizadores e Vaporizadores
Cooperação do Paciente/estatística & dados numéricos
Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico
[Mh] Termos MeSH secundário: Administração por Inalação
Idoso
Broncodilatadores/uso terapêutico
Combinação de Medicamentos
Feminino
Fluticasona/administração & dosagem
Seres Humanos
Masculino
Estudos Prospectivos
Xinafoato de Salmeterol/administração & dosagem
Xinafoato de Salmeterol/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Bronchodilator Agents); 0 (Drug Combinations); 6EW8Q962A5 (Salmeterol Xinafoate); CUT2W21N7U (Fluticasone)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170719
[Lr] Data última revisão:
170719
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160714
[St] Status:MEDLINE
[do] DOI:10.1164/rccm.201604-0733OC


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[PMID]:27959747
[Au] Autor:Nieto A; Mazón Á; Nieto M
[Ad] Endereço:Children's Hospital La Fe, Valencia, Spain nieto_ant@gva.es.
[Ti] Título:Salmeterol and Fluticasone Propionate in Children with Asthma.
[So] Source:N Engl J Med;375(22):e46, 2016 12 01.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Asma/tratamento farmacológico
Fluticasona
[Mh] Termos MeSH secundário: Administração por Inalação
Albuterol/uso terapêutico
Androstadienos/uso terapêutico
Antiasmáticos/uso terapêutico
Broncodilatadores/uso terapêutico
Criança
Combinação de Medicamentos
Seres Humanos
Xinafoato de Salmeterol
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
0 (Androstadienes); 0 (Anti-Asthmatic Agents); 0 (Bronchodilator Agents); 0 (Drug Combinations); 6EW8Q962A5 (Salmeterol Xinafoate); CUT2W21N7U (Fluticasone); QF8SVZ843E (Albuterol)
[Em] Mês de entrada:1612
[Cu] Atualização por classe:170123
[Lr] Data última revisão:
170123
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161214
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMc1612973



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