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[PMID]:29401500
[Au] Autor:Shields MD; ALQahtani F; Rivey MP; McElnay JC
[Ad] Endereço:Centre for Infection and Immunity. School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom.
[Ti] Título:Mobile direct observation of therapy (MDOT) - A rapid systematic review and pilot study in children with asthma.
[So] Source:PLoS One;13(2):e0190031, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We describe, for the first time, the use of a mobile device platform for remote direct observation of inhaler use and technique. The research programme commenced with a rapid systematic review of mobile device (or videophone) use for direct observation of therapy (MDOT). Ten studies (mainly pilots) were identified involving patients with tuberculosis, sickle cell disease and Alzheimer's disease. New studies are ongoing (ClinicalTrials.gov website) in TB, stroke, sickle cell disease, HIV and opioid dependence. Having identified no prior use of MDOT in inhaler monitoring, we implemented a feasibility study in 12 healthy volunteer children (2-12 years; 8 females and 4 males) over a period of 14 days, with twice daily video upload of their 'dummy' inhaler use. Two children uploaded 100% of the requested videos, with only one child having an inhaler upload rate of <75%. The quality of uploaded videos was generally good (only 1.7% of unacceptable quality for evaluation). The final aspect of the research was a pilot study using MDOT (6 weeks) in 22 children with difficult to treat asthma. Healthcare professionals evaluated inhaler technique using uploaded videos and provided telephone instruction on improving inhaler use. The main outcomes were assessed at week 12 post initiation of MDOT. By week 5, all children still engaging in MDOT (n = 18) were judged to have effective inhaler technique. Spirometry values did not vary to a significantly significant degree between baseline and 12 weeks (P>0.05), however, mean fraction of exhaled nitric oxide (FeNO) values normalised (mean 38.7 to 19.3ppm) and mean Asthma Control Test values improved (13.1 to mean 17.8). Feedback from participants was positive. Overall the findings open up a new paradigm in device independent (can be used for any type of inhaler device) monitoring, providing a platform for evaluating / improving inhaler use at home.
[Mh] Termos MeSH primário: Antiasmáticos/uso terapêutico
Asma/tratamento farmacológico
Terapia Diretamente Observada
Smartphone
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Feminino
Seres Humanos
Masculino
Nebulizadores e Vaporizadores
Cooperação do Paciente
Projetos Piloto
Ensaios Clínicos Controlados Aleatórios como Assunto
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Asthmatic Agents)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180206
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190031


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[PMID]:29449208
[Au] Autor:Keeley D
[Ad] Endereço:Thame OX9 3JF, UK.
[Ti] Título:Everyone with asthma should have a metered dose inhaler and a spacer.
[So] Source:BMJ;360:k648, 2018 02 15.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Asma
Nebulizadores e Vaporizadores
[Mh] Termos MeSH secundário: Administração por Inalação
Albuterol
Broncodilatadores
Seres Humanos
Inaladores Dosimetrados
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
0 (Bronchodilator Agents); QF8SVZ843E (Albuterol)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180217
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.k648


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[PMID]:29288167
[Au] Autor:Bush A; Griffiths C
[Ad] Endereço:National Heart and Lung Institute, Royal Brompton Harefield NHS Foundation Trust, London, UK a.bush@imperial.ac.uk.
[Ti] Título:Improving treatment of asthma attacks in children.
[So] Source:BMJ;359:j5763, 2017 12 29.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Asma/complicações
Asma/tratamento farmacológico
[Mh] Termos MeSH secundário: Doença Aguda
Agonistas de Receptores Adrenérgicos beta 2/uso terapêutico
Asma/fisiopatologia
Asma/prevenção & controle
Progressão da Doença
Serviço Hospitalar de Emergência/normas
Seres Humanos
Hipóxia/complicações
Espaçadores de Inalação/utilização
Nebulizadores e Vaporizadores/normas
Oxigenoterapia/métodos
Reino Unido/epidemiologia
[Pt] Tipo de publicação:EDITORIAL
[Nm] Nome de substância:
0 (Adrenergic beta-2 Receptor Agonists)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180303
[Lr] Data última revisão:
180303
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171231
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5763


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[PMID]:29364929
[Au] Autor:Price DB; Gefen E; Gopalan G; McDonald R; Thomas V; Ming SWY; Davis E
[Ad] Endereço:Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom.
[Ti] Título:Real-life effectiveness and safety of salbutamol Steri-Neb™ vs. Ventolin Nebules® for exacerbations in patients with COPD: Historical cohort study.
[So] Source:PLoS One;13(1):e0191404, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Ventolin Nebules® (reference product; GlaxoSmithKline) was the first licensed nebulizer solution containing the rapid-onset, short-acting ß2-agonist salbutamol. Salbutamol Steri-Neb™ (comparator; Teva Pharmaceuticals, Inc.) has the same chemical composition as the reference product. This study evaluated whether the effectiveness of the comparator is non-inferior to the reference product alongside concomitant medications during real-life clinical management of COPD exacerbations. Safety in terms of adverse events (AEs) was also examined. METHODS: This matched (1:1) historical cohort study evaluated data from 2 UK primary care databases on patients prescribed the salbutamol comparator or reference. The study included a 1-year baseline period, starting 1 year before the index prescription date, and 1-year outcome period. Cohorts were matched for baseline COPD respiratory medications. The primary outcome was analysis of non-inferiority for the comparator versus reference product for the rate of moderate and severe COPD exacerbations. Non-inferiority was satisfied if the 95% confidence interval (CI) upper limit for mean differences in proportions between treatments was <15%. Secondary outcomes were examined through rate ratios (RR) of severe exacerbations and AEs. RESULTS: After matching, 1191 patients were included in each cohort. Adjusted upper 95% CI for the difference in proportion of patients experiencing moderate or severe exacerbations between comparator and reference groups was 0.032 (3.2%), demonstrating non-inferiority. No significant differences were observed in rates of moderate and severe exacerbations (RR: 1.00; 95% CI: 0.91, 1.10), severe exacerbations (RR: 0.76; 95% CI: 0.49, 1.17), or AEs (RR: 0.98; 95% CI: 0.78, 1.22) after adjusting for baseline confounders. No significant differences across cohorts were observed for rates of any AE or death. CONCLUSION: This matched cohort study of real-life management of COPD patients supports the salbutamol comparator as non-inferior to the reference product, providing an effective treatment alternative for COPD exacerbations. Comparator and reference safety profiles were similar.
[Mh] Termos MeSH primário: Agonistas de Receptores Adrenérgicos beta 2/administração & dosagem
Albuterol/administração & dosagem
Broncodilatadores/administração & dosagem
Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico
[Mh] Termos MeSH secundário: Administração por Inalação
Agonistas de Receptores Adrenérgicos beta 2/efeitos adversos
Adulto
Idoso
Idoso de 80 Anos ou mais
Albuterol/efeitos adversos
Broncodilatadores/efeitos adversos
Estudos de Coortes
Progressão da Doença
Feminino
Seres Humanos
Masculino
Meia-Idade
Nebulizadores e Vaporizadores
Doença Pulmonar Obstrutiva Crônica/fisiopatologia
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Adrenergic beta-2 Receptor Agonists); 0 (Bronchodilator Agents); QF8SVZ843E (Albuterol)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191404


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[PMID]:28467361
[Au] Autor:Francioso A; Cossi R; Fanelli S; Mastromarino P; Mosca L
[Ad] Endereço:Department of Biochemical Sciences, "Sapienza" University of Rome, Piazzale Aldo Moro, 5, 00185 Roma, Italy. antonio.francioso@uniroma1.it.
[Ti] Título:Studies on Trans-Resveratrol/Carboxymethylated (1,3/1,6)-ß-d-Glucan Association for Aerosol Pharmaceutical Applications.
[So] Source:Int J Mol Sci;18(5), 2017 May 03.
[Is] ISSN:1422-0067
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:A resveratrol/carboxymethylated glucan (CM-glucan) combination is known to inhibit rhinovirus replication and expression of inflammatory mediators in nasal epithelia. The aim of this study was to develop an aerosol formulation containing an association of the two molecules which could reach the lower respiratory tract. Mass median aerodynamic diameter (MMAD) of a resveratrol/CM-glucan combination was lower than that shown by resveratrol or CM-glucan alone (2.83 versus 3.28 and 2.96 µm, respectively). The resveratrol/CM-glucan association results in the finest and most monodispersed particles in comparison to the two single components. The association also evidenced lower values for all particle size distribution parameters, suggesting that the pharmacological synergy observed in previous studies may be accompanied by a pharmaceutical one. Moreover, we showed that the CM-glucan matrix did not exert an inhibitory effect on resveratrol nebulization, demonstrating the good suitability of these two molecules in association for simultaneous aerosol volatilization.
[Mh] Termos MeSH primário: Anti-Inflamatórios não Esteroides/química
Anti-Inflamatórios não Esteroides/farmacologia
Antivirais/química
Antivirais/farmacologia
Estilbenos/química
Estilbenos/farmacologia
beta-Glucanas/química
[Mh] Termos MeSH secundário: Aerossóis
Sobrevivência Celular/efeitos dos fármacos
Células HeLa
Seres Humanos
Mucosa Nasal
Nebulizadores e Vaporizadores
Tamanho da Partícula
Rhinovirus/efeitos dos fármacos
Volatilização
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Aerosols); 0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Antiviral Agents); 0 (Stilbenes); 0 (beta-Glucans); 9051-97-2 (beta-1,3-glucan); Q369O8926L (resveratrol)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE


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[PMID]:29365382
[Au] Autor:Chen QP; Zhou RF; Zhang YM; Yang L
[Ad] Endereço:Department of Paediatrics, Taizhou People's Hospital, Taizhou 225300, China.
[Ti] Título:[Efficacy of systemic glucocorticoids combined with inhaled steroid on children with acute laryngitis].
[So] Source:Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi;53(1):53-56, 2018 Jan 07.
[Is] ISSN:1673-0860
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To evaluate the efficacy of systemic glucocorticoid (steroid) combined with high dose inhaled steroid in the treatment of children with acute laryngitis. A total of 78 children with acute laryngitis were randomly divided into study group( =40) and control group( =38) between November 2016 and April 2017. In addition to routine treatment of anti infection and symptomatic treatment, Dexamethasone injection(0.3-0.5 mg/kg, 1-3 d, according to the patient's condition) was provided to each group. In addition to the treatment mentioned above, the study group were assigned to receive 1.0 mg Budesonide suspension for inhalation, oxygen-driven atomizing inhalation, every/30 minutes, 2 times in a row, after that every 12 hours. The improvement of inspiratory dyspnea, hoarseness, barking cough and wheezing of both groups was evaluated at 30 min, 1 h, 2 h, 6 h, 12 h, 24 h and 72 h after treatment.Sigmaplot 11.5 software was used to analyze the data. No significant difference was detected in terms of inspiratory dyspnea, hoarseness, barking cough or stridor score before treatment between the two groups( >0.05). Compared with those before treatment, symptoms of inspiratory dyspnea, hoarseness, barking cough and stridor score of both groups improved markedly at 12 h and 24 h after treatment( <0.05). While there was no significant difference regarding inspiratory dyspnea, hoarseness, barking cough or stridor score at each time point after treatment between the two groups( >0.05). The effective rate was 92.50% and 92.11% in study group and control group, respectively, and no significant difference was noted ( >0.05). Compared with single systemic glucocorticoid, systemic glucocorticoids combined with inhaled steroid possessed similar efficacy in treating acute laryngitis and relieving laryngeal obstruction of children.
[Mh] Termos MeSH primário: Budesonida/uso terapêutico
Dexametasona/uso terapêutico
Glucocorticoides/uso terapêutico
Laringite/tratamento farmacológico
[Mh] Termos MeSH secundário: Doença Aguda
Administração por Inalação
Budesonida/administração & dosagem
Criança
Tosse/tratamento farmacológico
Dexametasona/administração & dosagem
Esquema de Medicação
Dispneia/tratamento farmacológico
Glucocorticoides/administração & dosagem
Rouquidão/tratamento farmacológico
Seres Humanos
Nebulizadores e Vaporizadores
Sons Respiratórios/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Glucocorticoids); 51333-22-3 (Budesonide); 7S5I7G3JQL (Dexamethasone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1673-0860.2018.01.012


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[PMID]:29197897
[Au] Autor:Beasley R; Hancox RJ
[Ad] Endereço:Medical Research Institute of New Zealand, Wellington, Capital & Coast District Health Board, Wellington.
[Ti] Título:New Zealand asthma guidelines updated.
[So] Source:N Z Med J;130(1466):7-9, 2017 12 01.
[Is] ISSN:1175-8716
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Mh] Termos MeSH primário: Asma/diagnóstico
Asma/terapia
[Mh] Termos MeSH secundário: Adolescente
Corticosteroides/administração & dosagem
Criança
Seres Humanos
Nebulizadores e Vaporizadores
Nova Zelândia
Guias de Prática Clínica como Assunto
Sociedades Médicas
[Pt] Tipo de publicação:EDITORIAL
[Nm] Nome de substância:
0 (Adrenal Cortex Hormones)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171204
[St] Status:MEDLINE


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[PMID]:29265171
[Au] Autor:Zhang L; Mendoza-Sassi RA; Wainwright C; Klassen TP
[Ad] Endereço:Faculty of Medicine, Federal University of Rio Grande, Rua Visconde Paranaguá 102, Centro, Rio Grande, RS, Brazil, 96201-900.
[Ti] Título:Nebulised hypertonic saline solution for acute bronchiolitis in infants.
[So] Source:Cochrane Database Syst Rev;12:CD006458, 2017 12 21.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Airway oedema (swelling) and mucus plugging are the principal pathological features in infants with acute viral bronchiolitis. Nebulised hypertonic saline solution (≥ 3%) may reduce these pathological changes and decrease airway obstruction. This is an update of a review first published in 2008, and previously updated in 2010 and 2013. OBJECTIVES: To assess the effects of nebulised hypertonic (≥ 3%) saline solution in infants with acute bronchiolitis. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid MEDLINE Daily, Embase, CINAHL, LILACS, and Web of Science on 11 August 2017. We also searched the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov on 8 April 2017. SELECTION CRITERIA: We included randomised controlled trials and quasi-randomised controlled trials using nebulised hypertonic saline alone or in conjunction with bronchodilators as an active intervention and nebulised 0.9% saline, or standard treatment as a comparator in children under 24 months with acute bronchiolitis. The primary outcome for inpatient trials was length of hospital stay, and the primary outcome for outpatients or emergency department trials was rate of hospitalisation. DATA COLLECTION AND ANALYSIS: Two review authors independently performed study selection, data extraction, and assessment of risk of bias in included studies. We conducted random-effects model meta-analyses using Review Manager 5. We used mean difference (MD), risk ratio (RR), and their 95% confidence intervals (CI) as effect size metrics. MAIN RESULTS: We identified 26 new trials in this update, of which 9 await classification due to insufficient data for eligibility assessment, and 17 trials (N = 3105) met the inclusion criteria. We included a total of 28 trials involving 4195 infants with acute bronchiolitis, of whom 2222 infants received hypertonic saline.Hospitalised infants treated with nebulised hypertonic saline had a statistically significant shorter mean length of hospital stay compared to those treated with nebulised 0.9% saline (MD -0.41 days, 95% CI -0.75 to -0.07; P = 0.02, I² = 79%; 17 trials; 1867 infants) (GRADE quality of evidence: low). Infants who received hypertonic saline also had statistically significant lower post-inhalation clinical scores than infants who received 0.9% saline in the first three days of treatment (day 1: MD -0.77, 95% CI -1.18 to -0.36, P < 0.001; day 2: MD -1.28, 95% CI -1.91 to -0.65, P < 0.001; day 3: MD -1.43, 95% CI -1.82 to -1.04, P < 0.001) (GRADE quality of evidence: low).Nebulised hypertonic saline reduced the risk of hospitalisation by 14% compared with nebulised 0.9% saline among infants who were outpatients and those treated in the emergency department (RR 0.86, 95% CI 0.76 to 0.98; P = 0.02, I² = 7%; 8 trials; 1723 infants) (GRADE quality of evidence: moderate).Twenty-four trials presented safety data: 13 trials (1363 infants, 703 treated with hypertonic saline) did not report any adverse events, and 11 trials (2360 infants, 1265 treated with hypertonic saline) reported at least one adverse event, most of which were mild and resolved spontaneously. AUTHORS' CONCLUSIONS: Nebulised hypertonic saline may modestly reduce length of stay among infants hospitalised with acute bronchiolitis and improve clinical severity score. Treatment with nebulised hypertonic saline may also reduce the risk of hospitalisation among outpatients and emergency department patients. However, we assessed the quality of the evidence as low to moderate.
[Mh] Termos MeSH primário: Bronquiolite Viral/terapia
Solução Salina Hipertônica/administração & dosagem
[Mh] Termos MeSH secundário: Doença Aguda
Obstrução das Vias Respiratórias
Broncodilatadores/administração & dosagem
Seres Humanos
Lactente
Tempo de Internação
Nebulizadores e Vaporizadores
Readmissão do Paciente/estatística & dados numéricos
Ensaios Clínicos Controlados Aleatórios como Assunto
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Bronchodilator Agents); 0 (Saline Solution, Hypertonic)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD006458.pub4


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[PMID]:28450164
[Au] Autor:Kunda NK; Hautmann J; Godoy SE; Marshik P; Chand R; Krishna S; Muttil P
[Ad] Endereço:Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico, Albuquerque, NM, USA.
[Ti] Título:A novel approach to study the pMDI plume using an infrared camera and to evaluate the aerodynamic properties after varying the time between actuations.
[So] Source:Int J Pharm;526(1-2):41-49, 2017 Jun 30.
[Is] ISSN:1873-3476
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Plume characteristics, such as temperature and velocity, emitted from pMDIs could significantly affect the dose delivered to the lung. Currently, high speed cameras and thermocouples are used separately to evaluate these parameters. We used a low-noise infrared camera to evaluate both the temperature and velocity of the emitted plume from pMDIs. Additionally, we investigated whether the fine particle fraction (FPF) is affected when time between actuations is varied. We tested three different albuterol sulfate pMDIs: ProAir HFA, Proventil HFA, and Ventolin HFA. The plume and aerodynamic characteristics from these pMDIs were evaluated, after varying the time between actuations (15, 30, 60, and 120s), using the infrared camera and a next generation impactor, respectively. The aerodynamic characteristics were evaluated with and without a valved holding chamber (VHC). ProAir HFA had the softest plume followed by Proventil HFA and Ventolin HFA. Further, Ventolin HFA was slightly cooler and had significantly lower FPF than ProAir HFA and Proventil HFA. All inhalers had higher FPF when used with VHC. Further, we observed that the time between actuations affected the FPF across pMDIs. Moreover, generalized guidelines suggesting one-minute interval between actuations for pMDIs should be reconsidered, with and without a VHC.
[Mh] Termos MeSH primário: Albuterol/análise
Inaladores Dosimetrados
Tecnologia Farmacêutica
[Mh] Termos MeSH secundário: Administração por Inalação
Aerossóis
Nebulizadores e Vaporizadores
Tamanho da Partícula
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Aerosols); QF8SVZ843E (Albuterol)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180104
[Lr] Data última revisão:
180104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


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[PMID]:29210318
[Au] Autor:DePietro M; Gilbert I; Millette LA; Riebe M
[Ad] Endereço:a Medical Affairs , AstraZeneca LP , Wilmington , DE , USA.
[Ti] Título:Inhalation device options for the management of chronic obstructive pulmonary disease.
[So] Source:Postgrad Med;130(1):83-97, 2018 Jan.
[Is] ISSN:1941-9260
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Chronic obstructive pulmonary disease (COPD) is characterized by chronic respiratory symptoms and airflow limitation, resulting from abnormalities in the airway and/or damage to the alveoli. Primary care physicians manage the healthcare of a large proportion of patients with COPD. In addition to determining the most appropriate medication regimen, which usually includes inhaled bronchodilators with or without inhaled corticosteroids, physicians are charged with optimizing inhalation device selection to facilitate effective drug delivery and patient adherence. The large variety of inhalation devices currently available present numerous challenges for physicians that include: (1) gaining knowledge of and proficiency with operating different device classes; (2) identifying the most appropriate inhalation device for the patient; and (3) providing the necessary education and training for patients on device use. This review provides an overview of the inhalation device types currently available in the United States for delivery of COPD medications, including information on their successful operation and respective advantages and disadvantages, factors to consider in matching a device to an individual patient, the need for device training for patients and physicians, and guidance for improving treatment adherence. Finally, the review will discuss established and novel tools and technology that may aid physicians in improving education and promoting better adherence to therapy.
[Mh] Termos MeSH primário: Broncodilatadores/administração & dosagem
Glucocorticoides/administração & dosagem
Nebulizadores e Vaporizadores
Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico
[Mh] Termos MeSH secundário: Administração por Inalação
Fatores Etários
Seres Humanos
Adesão à Medicação
Seleção de Pacientes
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Bronchodilator Agents); 0 (Glucocorticoids)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180103
[Lr] Data última revisão:
180103
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.1080/00325481.2018.1399042



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