Pulmonary pharmacology & therapeutics
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Pulm Pharmacol Ther · Jan 2008
Randomized Controlled TrialChronic inhalation of nebulized levalbuterol does not increase mucociliary clearance in healthy subjects.
Acute inhalations of beta 2-adrenergic receptor agonists increase mucociliary clearance (MCC). Less is known about the effect of long-term inhalations of these agents on MCC, or cough clearance (CC). We hypothesized that chronic inhalations of nebulized levalbuterol, the R-isomer of albuterol, would enhance MCC and/or CC in healthy subjects, compared to albuterol or placebo. ⋯ MCC averaged (+/-SD) 12.3+/-8.3%, 9.2+/-4.7% and 10.0+/-9.6% with placebo, albuterol and levalbuterol, respectively. CC averaged 3.9+/-6.8%, 4.9+/-4.3% and 3.8+/-6.4% with placebo, albuterol and levalbuterol, respectively. These results indicate that chronic inhalations of nebulized levalbuterol for 1 week do not increase MCC or CC in healthy subjects, compared to albuterol or placebo.
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Pulm Pharmacol Ther · Jan 2008
Randomized Controlled TrialAcute effects of sildenafil on exercise pulmonary hemodynamics and capacity in patients with COPD.
We investigated in chronic obstructive pulmonary disease (COPD) patients whether a single dose of sildenafil can attenuate the exercise-induced increase in pulmonary artery pressure, thereby allowing augmentation of stroke volume (SV), and improving maximal exercise capacity. ⋯ Regardless of mPpa at rest, sildenafil attenuates the increase in mPpa during submaximal exercise in COPD. This attenuated increase is neither accompanied by enhanced SV and CO, nor by improved maximal exercise capacity.
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Pulm Pharmacol Ther · Jan 2008
Randomized Controlled Trial Comparative StudyComparison of twice-daily inhaled ciclesonide and fluticasone propionate in patients with moderate-to-severe persistent asthma.
To investigate the relative efficacy of ciclesonide and fluticasone propionate (FP) administered at comparable microgram doses in maintaining asthma control in patients with moderate-to-severe persistent asthma. ⋯ Ciclesonide 320 microg and FP 330 microg administered twice daily over 6 months provided similar efficacy in patients with moderate or severe persistent asthma previously well-controlled by high doses of ICS at baseline. Ciclesonide was associated with fewer local AEs than FP.
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Pulm Pharmacol Ther · Jan 2008
Randomized Controlled TrialEffects of airway anesthesia on dyspnea and ventilatory response to intravenous injection of adenosine in healthy human subjects.
We have recently shown that intravenous injection of adenosine causes dyspnea and hyperventilation in man, and we suggested that stimulation of vagal C-fibers in the airways and lungs is involved. To test this hypothesis further, the present study was performed in healthy subjects (n=12; age 32.4+/-10.2 yrs, 7 females) to determine if the effect of adenosine could be attenuated by blocking the airway sensory receptors by inhalation of aerosolized lidocaine, a local anesthetic. In each subject, the effects of intravenous injection of adenosine (10mg) on dyspneic sensation, minute ventilation, airway resistance and heart rate were measured after the subject inhaled lidocaine or placebo aerosol on two separate days. ⋯ The intensity of adenosine-induced dyspnea was markedly reduced after the lidocaine pretreatment compared to placebo. In a sharp contrast, the VE and heart rate responses to adenosine were not affected by lidocaine. These results lend further support to our previous studies indicating that the origin of the dyspnogenic action of intravenous adenosine is most likely vagal bronchopulmonary C-fiber sensory nerves.
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Pulm Pharmacol Ther · Jan 2007
Randomized Controlled TrialThe effect of codeine on the Urge-to-Cough response to inhaled capsaicin.
We have shown previously in normal subjects that a sensory measure, the Urge-to-Cough rating, increases at concentrations of inhaled capsaicin that are lower than those necessary to elicit reflex cough. This finding suggests that the Urge-to-Cough may represent an index of the cough response. Research on cough in the human has most often employed challenge with inhaled capsaicin to induce reflex cough. ⋯ These results showed that the initial threshold for responding to capsaicin-induced cough is the perception of an Urge-to-Cough, followed by a motor cough response if the capsaicin is increased above the perceptual threshold. As the capsaicin concentration increases, both the perceptual need to cough and the cough motor response increase. The response of subjects to inhalation of capsaicin consisted of both a sensory component leading to perception of an Urge-to-Cough and motor cough behavior.