Biomedical subjects
Publications and source records attributed to P Chervinsky.
A 5% solution of metaproterenol, 10 whiffs (1.5 mg) q.i.d., was administered from a hand bulb nebulizer to 28 asthmatics for 60 days. Spirometry in double-blind, crossover tests against an 0.5% isoproterenol solution on days 0-1 and 59-60 and global evaluations of response showed that metaproterenol was more effective and longer acting. No tolerance to metaproterenol developed. Side-effects were negligible.
Corticosteroids, originally developed as topical agents, have proved effective in aerosol form in the treatment of asthma. Of 33 chronic bronchial asthmatic patients dependent on oral corticosteroids, 16 were randomly selected for treatment with triamcinolone acetonide aerosol and 17 for treatment with triamcinolone acetonide aerosol and 17 for treatment with placebo to determine the effectiveness of the active drug and the feasibility of eliminating or reducing oral steroids. Aerosol dosages of 800 g daily continued for 12 weeks. The patients improved about 30, 50 and 60% in mean FVC, FEV1, and FEF25 75, respectively. Their mean oral steroid dose dropped 77%, with 13 of the 16 discontinuing oral steroids entirely, and their asthma symptoms decreased about 30%. Placebo patients showed minimal or no improvement in these areas. The clinical results indicated that 14 of 16 active aerosol and 4 of 17 placebo aerosol patients improved over baseline. No side effects or fungal infections appeared and only two patients experienced oral-steroid withdrawal symptoms.
Fenoterol and isoproterenol metered-dose inhalers were compared in 30 asthmatic patients by a double-blind, parallel-group study. FEV1 and FEF 25-75% values recorded after single doses on days 1, 45 and 90 of a three-month continuous treatment period showed that mean increases over baseline were significantly greater and lasted longer with fenoterol.
In a double-blind, randomized study, 93 corticosteroid-independent patients with chronic bronchial asthma were treated with either beclomethasone dipropionate aerosol at 400 mug per day of its vehicle for 4 wk to determine and compare the effectiveness and safety of the preparations. Evaluations made before, at weekly intervals during, and 1 wk after treatment indicated that beclomethasone dipropionate aerosol was superior to its vehicle is improving FVC, FEV1, FEF25%--75%, and clinical signs and symptoms, and in the overall evaluations by both the investigators and the patients. Plasma cortisol levels measured at the end of the second and fourth weeks were not substantially different from those before treatment in either group. No significant side effects or abnormalities in laboratory results were noted.
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A six-month clinical trial of Alupent Syrup was conducted in 23 school-age children with bronchial asthma to assess the long-term efficacy and safety of this dosage form of metaproterenol sulfate. At three intervals during the study period, double-bind crossover tests against placebo were performed. Pulmonary function measurements revealed significant improvement in PEFR and FEV, after metaproterenol, and the results obtained at the end of ths study demonstrated that no tolerance to the drug had developed. The absence of adverse reactions attested to the safety of the drug in long-term management of childhood asthma.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A new double-strength (84 micrograms/spray) formulation of beclomethasone dipropionate (BDP-ds) as an aqueous suspension has been introduced to control symptoms of allergic rhinitis with once-daily intranasal dosing. This paper reviews the results of three clinical reports which show that BDP-ds given once a day is more effective than placebo and as effective as regular-strength beclomethasone dipropionate given twice daily in reducing the nasal symptoms of seasonal allergic rhinitis. Symptom improvement was seen within 2 days of treatment initiation and was maintained for the subsequent 4 weeks. BDP-ds was found to be as safe and well tolerated as placebo. Adverse effects, which were generally mild, included headache, nasal burning/irritation, epistaxis, coughing, and pharyngitis. BDP-ds is safe for children as young as 6 years of age, and its once-daily dosing schedule may improve patient compliance.
This study compared the efficacy and safety of mometasone furoate (MF) administered by metered dose inhaler (MDI) 56, 200 or 500 pg b.i.d., with beclomethasone dipropionate (BDP) 168 microg b.i.d. and placebo. Adult patients (n=395), with moderate persistent asthma (FEV1 50-90% of predicted normal), previously maintained on inhaled corticosteroids, were enrolled at 16 centres in a four-week, randomised, double-blind, double-dummy, multicentre, dose-ranging trial. At endpoint, FEV1 was significantly improved (p<0.01) with MF-MDI 56, 200 and 500 microg b.i.d., as well as with BDP (6%, 13%, 14% and 4%, respectively), compared with placebo (-12%). Mean change in FVC, FEF2575%, and a.m. and p.m. peak expiratory flow rate (PEFR) were also significantly improved for all active treatment groups at endpoint compared with placebo. Asthma symptoms and quality of life (SF-36) related to physical functioning improved with active treatments relative to placebo. All doses of MF-MDI were well tolerated. Treatment with MF-MDI 200 pg b.i.d. was superior to BDP MDI 168 microg b.i.d. or MF-MDI 56 microg b.i.d., with no additional benefit derived from a higher MF-MDI 500 microg b.i.d. dose. MF-MDI was well tolerated, with superior efficacy compared with BDP MDI in these patients with moderate persistent asthma.