The efficacy of slow versus faster inhalation of cromolyn sodium in protecting against allergen challenge in patients with asthma
Approximately one third of patients with allergy-induced asthma who are treated with aerosolized cromolyn sodium (CS) fail to achieve a full therapeutic effect. This lack of effectiveness could involve nonhomogeneous distribution of drug in the lung as a result of high inspiratory flow rates. We sou...
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| Veröffentlicht in: | Journal of allergy and clinical immunology 1998-04, Vol.101 (4), p.475-483 |
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| container_title | Journal of allergy and clinical immunology |
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| creator | LAUBE, B. L EDWARDS, A. M DALBY, R. N CRETICOS, P. S NORMAN, P. S |
| description | Approximately one third of patients with allergy-induced asthma who are treated with aerosolized cromolyn sodium (CS) fail to achieve a full therapeutic effect. This lack of effectiveness could involve nonhomogeneous distribution of drug in the lung as a result of high inspiratory flow rates.
We sought to determine the efficacy of slow versus faster inhalation of CS in protecting against allergen challenge in patients with asthma.
Eight patients with asthma underwent two allergen challenges 30 minutes after pretreatment with CS that was inhaled from a large holding chamber at approximately 30 L/min or approximately 70 L/min. Percent decreases in FEV1 at a common dose of allergen on the two challenge days were compared. Values of skew (an indicator of aerosol distribution homogeneity) obtained from gamma camera lung images after slow and faster inhalation of radiolabeled CS were also compared.
Mean (+/- SD) allergen-induced decrease in FEV1 was 5.4% +/- 4.2% after slow inspiration of CS, which was significantly less than the allergen-induced decrease in FEV1 after faster inhalation of CS with 12.6% +/- 11% (p < 0.05). Mean skew values were also significantly decreased after slow inspiration of CS, and differences in decreases in allergen FEV1 and skew values for the two breathing maneuvers were significantly correlated.
These data indicate that protection against allergen-induced asthma can be optimized by slowly inspiring CS from a large holding chamber compared with faster inhalation of the drug. These results appear to be related to enhanced distribution homogeneity of CS within the lungs. |
| doi_str_mv | 10.1016/S0091-6749(98)70376-8 |
| format | Article |
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We sought to determine the efficacy of slow versus faster inhalation of CS in protecting against allergen challenge in patients with asthma.
Eight patients with asthma underwent two allergen challenges 30 minutes after pretreatment with CS that was inhaled from a large holding chamber at approximately 30 L/min or approximately 70 L/min. Percent decreases in FEV1 at a common dose of allergen on the two challenge days were compared. Values of skew (an indicator of aerosol distribution homogeneity) obtained from gamma camera lung images after slow and faster inhalation of radiolabeled CS were also compared.
Mean (+/- SD) allergen-induced decrease in FEV1 was 5.4% +/- 4.2% after slow inspiration of CS, which was significantly less than the allergen-induced decrease in FEV1 after faster inhalation of CS with 12.6% +/- 11% (p < 0.05). Mean skew values were also significantly decreased after slow inspiration of CS, and differences in decreases in allergen FEV1 and skew values for the two breathing maneuvers were significantly correlated.
These data indicate that protection against allergen-induced asthma can be optimized by slowly inspiring CS from a large holding chamber compared with faster inhalation of the drug. These results appear to be related to enhanced distribution homogeneity of CS within the lungs.</description><identifier>ISSN: 0091-6749</identifier><identifier>EISSN: 1097-6825</identifier><identifier>DOI: 10.1016/S0091-6749(98)70376-8</identifier><identifier>PMID: 9564800</identifier><identifier>CODEN: JACIBY</identifier><language>eng</language><publisher>New York, NY: Elsevier</publisher><subject>Administration, Inhalation ; Adult ; Allergens - immunology ; Anti-Asthmatic Agents - administration & dosage ; Asthma - drug therapy ; Biological and medical sciences ; Cromolyn Sodium - administration & dosage ; Cromolyn Sodium - pharmacokinetics ; Female ; Forced Expiratory Volume - drug effects ; Humans ; Male ; Medical sciences ; Particle Size ; Pharmacology. Drug treatments ; Respiratory system</subject><ispartof>Journal of allergy and clinical immunology, 1998-04, Vol.101 (4), p.475-483</ispartof><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2211461$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9564800$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>LAUBE, B. L</creatorcontrib><creatorcontrib>EDWARDS, A. M</creatorcontrib><creatorcontrib>DALBY, R. N</creatorcontrib><creatorcontrib>CRETICOS, P. S</creatorcontrib><creatorcontrib>NORMAN, P. S</creatorcontrib><title>The efficacy of slow versus faster inhalation of cromolyn sodium in protecting against allergen challenge in patients with asthma</title><title>Journal of allergy and clinical immunology</title><addtitle>J Allergy Clin Immunol</addtitle><description>Approximately one third of patients with allergy-induced asthma who are treated with aerosolized cromolyn sodium (CS) fail to achieve a full therapeutic effect. This lack of effectiveness could involve nonhomogeneous distribution of drug in the lung as a result of high inspiratory flow rates.
We sought to determine the efficacy of slow versus faster inhalation of CS in protecting against allergen challenge in patients with asthma.
Eight patients with asthma underwent two allergen challenges 30 minutes after pretreatment with CS that was inhaled from a large holding chamber at approximately 30 L/min or approximately 70 L/min. Percent decreases in FEV1 at a common dose of allergen on the two challenge days were compared. Values of skew (an indicator of aerosol distribution homogeneity) obtained from gamma camera lung images after slow and faster inhalation of radiolabeled CS were also compared.
Mean (+/- SD) allergen-induced decrease in FEV1 was 5.4% +/- 4.2% after slow inspiration of CS, which was significantly less than the allergen-induced decrease in FEV1 after faster inhalation of CS with 12.6% +/- 11% (p < 0.05). Mean skew values were also significantly decreased after slow inspiration of CS, and differences in decreases in allergen FEV1 and skew values for the two breathing maneuvers were significantly correlated.
These data indicate that protection against allergen-induced asthma can be optimized by slowly inspiring CS from a large holding chamber compared with faster inhalation of the drug. These results appear to be related to enhanced distribution homogeneity of CS within the lungs.</description><subject>Administration, Inhalation</subject><subject>Adult</subject><subject>Allergens - immunology</subject><subject>Anti-Asthmatic Agents - administration & dosage</subject><subject>Asthma - drug therapy</subject><subject>Biological and medical sciences</subject><subject>Cromolyn Sodium - administration & dosage</subject><subject>Cromolyn Sodium - pharmacokinetics</subject><subject>Female</subject><subject>Forced Expiratory Volume - drug effects</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Particle Size</subject><subject>Pharmacology. Drug treatments</subject><subject>Respiratory system</subject><issn>0091-6749</issn><issn>1097-6825</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0E1r3DAQBmBREtJN2p-woEMJycGNJMuydCxLvmChhybnZSyP1iqyvLXkhD3mn9dpl73mpBHvw8swhCw5-84ZVze_GDO8ULU0V0Zf16ysVaE_kQVnpi6UFtUJWRzJZ3Ke0m82_0ttzsiZqZTUjC3I21OHFJ3zFuyeDo6mMLzSFxzTlKiDlHGkPnYQIPshvgM7Dv0Q9pGmofVTP6d0Nw4ZbfZxS2ELPqZMIQQctxip7d7HuMV_cG7BmBN99bmjc3vXwxdy6iAk_Hp4L8jz3e3T6qFY_7x_XP1YFzuhVC5QibbRrLJal8hcY7CpDCht2xasRicsQK1QWtkIw6Vl4FBIxi22vIIWygty-b933vbPhClvep8shgARhyltaqO5lqL6EPJa1FoqNcPlAU5Nj-1mN_oexv3mcNw5_3bIIVkIboRofToyITiXipd_AaBtjXo</recordid><startdate>19980401</startdate><enddate>19980401</enddate><creator>LAUBE, B. L</creator><creator>EDWARDS, A. M</creator><creator>DALBY, R. N</creator><creator>CRETICOS, P. S</creator><creator>NORMAN, P. S</creator><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>19980401</creationdate><title>The efficacy of slow versus faster inhalation of cromolyn sodium in protecting against allergen challenge in patients with asthma</title><author>LAUBE, B. L ; EDWARDS, A. M ; DALBY, R. N ; CRETICOS, P. S ; NORMAN, P. S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p266t-e62db805c883e0fb9eb59a68cddac8ef2caa76e4c4b2914c0afe2401ced15ada3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Administration, Inhalation</topic><topic>Adult</topic><topic>Allergens - immunology</topic><topic>Anti-Asthmatic Agents - administration & dosage</topic><topic>Asthma - drug therapy</topic><topic>Biological and medical sciences</topic><topic>Cromolyn Sodium - administration & dosage</topic><topic>Cromolyn Sodium - pharmacokinetics</topic><topic>Female</topic><topic>Forced Expiratory Volume - drug effects</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Particle Size</topic><topic>Pharmacology. Drug treatments</topic><topic>Respiratory system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>LAUBE, B. L</creatorcontrib><creatorcontrib>EDWARDS, A. M</creatorcontrib><creatorcontrib>DALBY, R. N</creatorcontrib><creatorcontrib>CRETICOS, P. S</creatorcontrib><creatorcontrib>NORMAN, P. S</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of allergy and clinical immunology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>LAUBE, B. L</au><au>EDWARDS, A. M</au><au>DALBY, R. N</au><au>CRETICOS, P. S</au><au>NORMAN, P. S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The efficacy of slow versus faster inhalation of cromolyn sodium in protecting against allergen challenge in patients with asthma</atitle><jtitle>Journal of allergy and clinical immunology</jtitle><addtitle>J Allergy Clin Immunol</addtitle><date>1998-04-01</date><risdate>1998</risdate><volume>101</volume><issue>4</issue><spage>475</spage><epage>483</epage><pages>475-483</pages><issn>0091-6749</issn><eissn>1097-6825</eissn><coden>JACIBY</coden><abstract>Approximately one third of patients with allergy-induced asthma who are treated with aerosolized cromolyn sodium (CS) fail to achieve a full therapeutic effect. This lack of effectiveness could involve nonhomogeneous distribution of drug in the lung as a result of high inspiratory flow rates.
We sought to determine the efficacy of slow versus faster inhalation of CS in protecting against allergen challenge in patients with asthma.
Eight patients with asthma underwent two allergen challenges 30 minutes after pretreatment with CS that was inhaled from a large holding chamber at approximately 30 L/min or approximately 70 L/min. Percent decreases in FEV1 at a common dose of allergen on the two challenge days were compared. Values of skew (an indicator of aerosol distribution homogeneity) obtained from gamma camera lung images after slow and faster inhalation of radiolabeled CS were also compared.
Mean (+/- SD) allergen-induced decrease in FEV1 was 5.4% +/- 4.2% after slow inspiration of CS, which was significantly less than the allergen-induced decrease in FEV1 after faster inhalation of CS with 12.6% +/- 11% (p < 0.05). Mean skew values were also significantly decreased after slow inspiration of CS, and differences in decreases in allergen FEV1 and skew values for the two breathing maneuvers were significantly correlated.
These data indicate that protection against allergen-induced asthma can be optimized by slowly inspiring CS from a large holding chamber compared with faster inhalation of the drug. These results appear to be related to enhanced distribution homogeneity of CS within the lungs.</abstract><cop>New York, NY</cop><pub>Elsevier</pub><pmid>9564800</pmid><doi>10.1016/S0091-6749(98)70376-8</doi><tpages>9</tpages></addata></record> |
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| subjects | Administration, Inhalation Adult Allergens - immunology Anti-Asthmatic Agents - administration & dosage Asthma - drug therapy Biological and medical sciences Cromolyn Sodium - administration & dosage Cromolyn Sodium - pharmacokinetics Female Forced Expiratory Volume - drug effects Humans Male Medical sciences Particle Size Pharmacology. Drug treatments Respiratory system |
| title | The efficacy of slow versus faster inhalation of cromolyn sodium in protecting against allergen challenge in patients with asthma |
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