Chest
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Randomized Controlled Trial
Effects of the Combination of Atomoxetine and Oxybutynin on Obstructive Sleep Apnea Endotypic Traits.
We recently showed that administration of the combination of the noradrenergic drug atomoxetine plus the antimuscarinic oxybutynin (ato-oxy) prior to sleep greatly reduced OSA severity, likely by increasing upper airway dilator muscle activity during sleep. In patients with OSA who performed the ato-oxy trial with an esophageal pressure catheter to estimate ventilatory drive, the effect of the drug combination (n = 17) and of the single drugs (n = 6) was measured on the endotypic traits over a 1-night administration and compared vs placebo. This study also tested if specific traits were predictors of complete response to treatment (reduction in apnea-hypopnea index [AHI] > 50% and < 10 events/h). ⋯ Ato-oxy markedly improved the measures of upper airway collapsibility, increased breathing stability, and slightly reduced the arousal threshold. Patients with relatively lower AHI and less severe upper airway collapsibility had the best chance for OSA resolution with ato-oxy.
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Randomized Controlled Trial
Effect of Olfactory Stimulation by L-menthol on Laboratory-Induced Dyspnea in Chronic Obstructive Pulmonary Disease.
Inhalation of L-menthol as a transient receptor potential melastatin 8 agonist induces a cooling sensation in the airway. This cooling sensation induced through olfactory stimulation by L-menthol (OSM) alleviates dyspnea in healthy humans. Therefore, we investigated effects of OSM on the neural respiratory drive (NRD) and multidimensional aspects of dyspnea induced by inspiratory resistive loaded breathing in COPD. ⋯ Our findings suggest that OSM activated the sense of inspiratory flow that achieved dyspnea relief in patients with COPD.
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Randomized Controlled Trial
Aprepitant for Cough Suppression in Advanced Lung Cancer: A Randomized Trial.
Although cough is a common and distressing symptom in patients with lung cancer, there is almost no evidence to guide treatment. Aprepitant, a centrally acting neurokinin-1 inhibitor, significantly decreased cough frequency in a pilot study. ⋯ Aprepitant led to a significant improvement in cough in advanced lung cancer, without increasing severe side effects.