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Biomedical subjects

C J Falliers

Publications and source records attributed to C J Falliers.

At least 37 records · Page 2Linked to original sources
PubMed1986

Use of ipratropium bromide in asthma. Results of a multi-clinic study.

A multi-center, double-blind, 90-day study compared an ipratropium bromide metered-dose inhaler (40 microgram four times a day) with a metaproterenol metered-dose inhaler (1,500 micrograms four times a day) in 164 patients with asthma; of the 144 patients who completed the study, 71 received ipratropium and 73 received metaproterenol. Our results suggest that both drugs were equally effective bronchodilators. Although the shape of the pulmonary function response curves suggested that ipratropium has different bronchodilator kinetics than metaproterenol (in that it has a slower onset of action and a more prolonged duration), comparison of the areas under the curves for the two drugs showed that there was no statistical difference between ipratropium or metaproterenol. The only significant side effects noted with ipratropium were cough and exacerbation of symptoms; no anticholinergic side effects were noted.

Administration, Inhalation↗
PubMed1986

Effect of single doses of labetalol, metoprolol, and placebo on ventilatory function in patients with bronchial asthma: interaction with isoproterenol.

The effects of labetalol, metoprolol, and placebo on pulmonary function and their interaction with isoproterenol were evaluated in 18 patients with reversible bronchial asthma [isoproterenol-induced increase in forced expiratory volume in 1 second (FEV1) of greater than or equal to 15%]. Two dose levels of each medication were studied (on consecutive days), with the lower doses of these drugs given randomly. When the lowest values during the 2-hour postdrug evaluation period were considered, FEV1 significantly increased (10.9%; 15.4%) following labetalol (200 and 400 mg, respectively), significantly decreased (-11.2%; -5.4%) after metoprolol (100 and 200 mg, respectively), and was unchanged after placebo. The effects of the three treatments on forced vital capacity (FVC) and maximal midexpiratory flow (MMEF) were qualitatively similar to those observed in FEV1. When isoproterenol was administered following labetalol (200 and 400 mg), FEV1 further increased with a resulting combined increase of 18.9 and 19.7%, respectively, indicating an additive interaction. The effect of isoproterenol was blunted by metoprolol (100 and 200 mg) (p less than 0.01, difference from the effect observed after labetalol and isoproterenol), indicating antagonistic interaction between these two drugs. Labetalol may be a safer antihypertensive than metoprolol in patients with concomitant bronchial asthma.

Adult↗
PubMed1986

Alternative drug therapy for asthma.

Individualized management of asthma requires consideration of single or combined pharmacologic alternatives. This article reviews experimental and clinical data on the efficacy, safety, mode of action, and therapeutic indications for cromolyn and related inhalational compounds; ketotifen; alpha-adrenergic blockers; calcium-channel blockers; nonsteroidal anti-inflammatory drugs; and such diverse agents as immunosuppressive drugs, ether, alcohol, ascorbic acid, and other nutritional substances.

Adrenergic alpha-Antagonists↗
PubMed1985

The effects of treatments with labetalol and hydrochlorothiazide on ventilatory function of asthmatic hypertensive patients with demonstrated bronchosensitivity to propranolol.

Fifty-two asthmatic patients with mild to moderate hypertension were screened for bronchosensitivity to propranolol in a double-blind randomized fashion after a 2-week minimum placebo run-in period. Thirty-five patients qualified on the basis of a decrease in 1-second forced expiratory volume FEV1 by greater than or equal to 20% after 80 mg of propranolol with no more than a +/- 15% change after placebo. Of these patients, 18 were then randomly assigned to antihypertensive treatment with labetalol at doses that were increased at weekly intervals (100, 200, 400, 600 mg BID) and 17, with hydrochlorothiazide (HCTZ) (25 or 50 mg BID) as needed for control of hypertension. At each placebo washout visit and at each of the four active drug-treatment phase visits, spirometric measurements were obtained just prior to the morning dose of medication and again 2 hours later on the initial visit (i.e., following the initial dose of active treatment) and on each visit when the dosage was increased. Neither HCTZ nor labetalol (average daily doses at the end of the study were 88 and 555 mg, respectively) caused bronchoconstriction: Mean FEV1 did not change from the baseline neither prior to the morning dose (evaluation of the "chronic" treatment effect) nor 2 hours after dosing (evaluation of "acute" treatment effect). Three patients in each treatment group reported increased dyspnea and two on labetalol and one on HCTZ had increased wheezing; the mean weekly isoproterenol usage per patients was similar for the two treatments (1.3 times/week/pt for labetalol and 1.6 times/week/pt for HCTZ).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Assessment of tachyphylaxis following prolonged therapy of asthma with inhaled albuterol aerosol.

Controversy exists concerning possible tachyphylaxis of the acute bronchodilating effect of albuterol, especially with regard to the duration of its acute bronchodilating action. We evaluated 140 patients with bronchial asthma in a prospective double-blind controlled study of possible tachyphylaxis to albuterol aerosol as compared to isoproterenol aerosol. We demonstrated statistically significant tachyphylaxis with regard to duration of acute bronchodilating effect. We believe that this tachyphylaxis is not clinically significant because there was no tachyphylaxis with regard to peak bronchodilating effect and because the duration of bronchodilating effect remains significantly greater, both quantitatively and statistically, when compared to isoproterenol aerosol. Moreover, it appeared that most of the tachyphylaxis was present at four weeks of therapy. There was a small increment of tachyphylaxis after eight weeks of therapy, but no further increase in tachyphylaxis was demonstrated after 13 weeks of inhaled albuterol therapy. We therefore feel that clinically significant tachyphylaxis to inhaled albuterol aerosol must be quite unusual and that chronic therapy with inhaled albuterol aerosol is probably both safe and efficacious for bronchospastic disorders.

Adolescent↗
PubMed1983

Factorial rating system for comparative efficacy of antiasthmatic medication: a multicentric study report.

Faced with 1-year daily medication diaries from over 300 patients, each documenting the use of from one to five medications a day, we found it was necessary to devise a system which would reduce this data into a form which would allow a meaningful interpretation of changes of medications in a single patient or group of patients. Since the medications were principally steroids, beta agonists, or xanthines, representative agents were chosen as the standard for each class and the other medications were rated against them. A conversion factor was then determined to allow comparison between classes. Each medication taken by a patient could now be expressed as a single number and the sum of all the medications would be the individual's Asthma Medication Index. The AMI allowed (i) evaluation of a single patient over time, (ii) comparison of different patients at any single point or over a period of time, and (iii) evaluation of entire groups of patients over time as was the case in our evaluation of Zaditen. Application of the system allowed the differentiation of two therapeutic agents versus placebo during a 1-year study, revealing excellent correlation with the physician's global assessment of the patient's improvement. With proper modification of the basic drug groups and intergroup factor relationship, the Index can be adapted to any disease state where a change in concomitant medication is an indicator of therapeutic effect.

Administration, Oral↗
PubMed1983

Acetaminophen and aspirin challenges in subgroups of asthmatics.

To determine whether the different modes of action of aspirin and acetaminophen are associated with different incidences of bronchoconstriction, and whether there is cross-reactivity in terms of intolerance, selected asthmatics were challenged with both analgesics. Clinical profiles were observed to characterize more precisely the aspirin-intolerant asthmatic. Inhalational challenges with PGF2 alpha were then performed on nine selected subjects. It was determined that a positive history of aspirin intolerance is a reliable indicator of potential for anaphylactoid reactions but is not associated with any detectable risk of acetaminophen intolerance. Inhalational PGF2 alpha tends to involve the larger airways; oral aspirin affects both large and small airways.

Acetaminophen↗