Pharmacotherapy in chronic obstructive pulmonary disease

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Sprache:English
Veröffentlicht: New York [u.a.] Dekker 2004
Schriftenreihe:Lung biology in health and disease 182
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Datensatz im Suchindex

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adam_text Introduction Claude Lenfant, M.D. Hi Preface v Contributors ix Part One THE APPLICATION OF CLINICAL ASSESSMENT TO THE DRUG DEVELOPMENT PROCESS 1. Providing Evidence of Therapeutic Benefit in Clinical Drug Development 1 Steven Kesten and Theodore J. Witek I. Introduction 1 II. Regulation in the Development of Drugs 2 III. Key Considerations in Clinical Program Designs 3 IV. Key Considerations in Endpoints: Application to COPD 6 V. Summary 14 References 15 xi xii Contents Part Two MEASURING OUTCOMES A. Physiology 2. Use of Expiratory Airflows and Lung Volumes to Assess Outcomes in COPD 19 Gary T. Ferguson I. Introduction 19 II. Expiratory Airflows 19 III. Lung Volumes 25 IV. Other Measures 31 V. Bronchodilator Reversibility and Airway Hyperreactivity 32 VI. Clinical Relevance 32 VII. Conclusion and Recommendations 37 References 38 3. Exercise Testing 45 Denis E. O Donnell and Katherine A. Webb I. Introduction 45 II. Exercise Limitation in COPD 46 III. Exercise Testing: Field Tests 54 IV. Exercise Testing: Laboratory Tests 56 V. Failure to Improve Exercise Performance After Bronchodilators 57 VI. Evaluating Mechanisms of Functional Improvement 58 VII. Utility of Constant Load Exercise Testing: Examples 61 VIII. Summary 65 References 66 4. Sleep Related Breathing Disturbances in COPD 73 Walter T. McNicholas I. Introduction 73 II. Effects of Sleep on Respiration 74 III. Sleep in Chronic Obstructive Pulmonary Disease 76 IV. Mechanisms of Nocturnal Oxygen Desaturation in COPD 76 V. Consequences of Nocturnal Hypoxaemia in COPD 77 VI. Sleep Quality in COPD 78 Contents xiii VII. Contrasts with Exercise 79 VIII. Investigation of Sleep Related Breathing Disturbances in COPD 79 IX. Management of Respiratory Abnormalities During Sleep in COPD 80 X. Pharmacological Therapy 81 XI. Conclusion 84 References 84 5. Airway and Alveolar Determinants of Airflow Limitation in COPD 89 Noe Zamel I. Introduction 89 II. Large Airways Airflow Limitation 89 III. Small Airways Airflow Limitation 91 IV. Alveolar Airflow Limitation 93 References 94 6. Gas Exchange 95 Antoni Ferrer, Joan Albert Barberd, and Roberto Rodriguez Roisin I. Introduction 95 II. Bronchodilators 96 HI. Glucocorticosteroids 106 IV. Vasodilators 108 V. Other Drugs 110 References 110 B. Laboratory 7. Genetics of COPD 119 Jian Qing He, Ikuma Kasuga, and Peter D. Pare I. Introduction 119 II. Evidence of Genetic Risk 120 III. Methods to Identify Susceptibility Genes 120 IV. Phenotypes 122 V. Candidate Genes in COPD 123 xiv Contents VI. Therapeutic Implications of COPD Genetics 134 VII. Pharmacogenetics of COPD 134 VIII. Conclusion 135 References 136 C. Health Outcomes 8. Dyspnea 145 Donald A. Mahler I. Introduction 145 II. The Measurement of Dyspnea 146 III. Responsiveness 151 IV. Summary 154 References 154 9. Exacerbations of COPD 159 Jadwiga A. Wedzicha I. Definition of a COPD Exacerbation 159 II. Exacerbation Frequency 160 III. Goals of Exacerbation Therapy 161 IV. Therapy of the Acute Exacerbation 161 V. Prevention of COPD Exacerbation 166 VI. Conclusion 170 References 170 10. Health Status Measurement in COPD 175 Paul W. Jones I. Introduction: The Multifactorial Nature of COPD 175 II. Measuring the Overall Effect of Treatment 177 III. Health Status Questionnaires 177 IV. Thresholds for Clinical Significance 180 V. Health Status Changes Following Treatment 180 VI. Longitudianl Trends in Health Status 182 VII. Implications for Practice 182 VIII. Assessment of Individual Patient Benefit 183 IX. Summary 184 References 184 Contents xv 11. Health Resource Utilization 189 Mitchell Friedman I. COPD—The Challenge 189 II. Helath Care Utilization in COPD 191 III. Economic Burden of COPD 194 References 199 Part Three SPECIFIC THERAPY 12. Anticholinergics 201 Peter J. Barnes I. Introduction 201 II. Rationale for Anticholinergic Therapy in COPD 202 III. Muscarinic Receptor Subtypes in the Airways 203 IV. The Search for Selective Anticholinergics 207 V. Tiotropuim Bromide 207 VI. Pharmacokinetics 209 VII. Side Effects 210 VIII. Future Prospects 211 References 212 13. P Adrtnergic Receptor Agonist Bronchodilators in the Treatment of COPD 217 Stephen I. Rennard I. Introduction 217 II. Mechanism of Action 218 III. Clinical Response 225 IV. Adverse Effects of (i Agonists 228 V. Clinical Assessment of the COPD patient 229 VI. Effect of Dyspnea 229 VII. Effect on Exercise 230 VIII. Quality of Life 230 IX. Exacerbations 230 X. Use of (3 Agonist Bronchodilators in Clinical Practice 231 XI. Summary 232 References 233 xvi Contents 14. Theophylline and Phosphodiesterase Inhibitors in COPD 239 Alicia R. ZuWallack and Richard L. ZuWallack I. Introduction 239 II. Molecular Mechanisms of Action of Theophylline and Other PDE Inhibitors 240 III. Pharmacological Effects of Theophylline 242 IV. Pharmacokinetics 243 V. Dosing and Monitoring of Theophylline 245 VI. Toxicity 248 VII. The Effectiveness of Theophylline on Important Outcomes for COPD 248 VIII. Selective Phosphodiesterase Inhibitors in the Treatment of COPD 254 IX. The Role of Theophylline in the Acute Exacerbation of COPD 257 X. Theophylline and Phosphodiesterase Inhibitors Use in COPD: Where Does It Fit In? 257 References 259 15. Corticosteroids in COPD 265 Mario Cazzola, Maria Gabriella Matera, and Romain Pauwels I. Introduction 265 II. Impact of Corticosteroids on Inflammation in COPD 268 III. Clinical Effects of Corticosteroids in COPD 269 IV. Adverse Effects 281 V. Corticosteroids and Guidelines 282 VI. Combining an Inhaled Corticosteroid and a Long Acting p2 Agonist in COPD 287 VII. Conclusion 290 References 291 16. Antioxidants and Protease Inhibitors 299 Mario Cazzola and Maria Gabriella Matera I. Introduction 299 II. Oxidative Stress and COPD 299 Contents xvii III. Proteases and COPD 312 IV. Conclusions 318 References 318 17. An Integrated Approach to the Pharmacological Therapy of COPD 327 Bartolome R. Celli I. Introduction 327 II. Change in Paradigm: A Constructive Analogy with Systemic Hypertension 328 III. Proof of Concept 330 IV. COPD: A Pulmonary Disease with Systemic Consequences 331 V. General Principles of Pharmacological Therapy in COPD 333 VI. Initiation of Drug Therapy 334 VII. Use of Corticosteroids 337 VIII. Other Medications 338 IX. Management of Acute Exacerbations 339 X. Summary and Conclusion 341 References 341 Index 347
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publishDate 2004
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series Lung biology in health and disease
series2 Lung biology in health and disease
spellingShingle Pharmacotherapy in chronic obstructive pulmonary disease
Lung biology in health and disease
Poumons - Maladies obstructives - Chimiothérapie
Drug Evaluation
Lungs Diseases, Obstructive Chemotherapy
Pulmonary Disease, Chronic Obstructive drug therapy
Obstruktive Ventilationsstörung (DE-588)4213128-5 gnd
Pharmakotherapie (DE-588)4076066-2 gnd
subject_GND (DE-588)4213128-5
(DE-588)4076066-2
(DE-588)4143413-4
title Pharmacotherapy in chronic obstructive pulmonary disease
title_auth Pharmacotherapy in chronic obstructive pulmonary disease
title_exact_search Pharmacotherapy in chronic obstructive pulmonary disease
title_full Pharmacotherapy in chronic obstructive pulmonary disease Ed. by Bartolome R. Celli
title_fullStr Pharmacotherapy in chronic obstructive pulmonary disease Ed. by Bartolome R. Celli
title_full_unstemmed Pharmacotherapy in chronic obstructive pulmonary disease Ed. by Bartolome R. Celli
title_short Pharmacotherapy in chronic obstructive pulmonary disease
title_sort pharmacotherapy in chronic obstructive pulmonary disease
topic Poumons - Maladies obstructives - Chimiothérapie
Drug Evaluation
Lungs Diseases, Obstructive Chemotherapy
Pulmonary Disease, Chronic Obstructive drug therapy
Obstruktive Ventilationsstörung (DE-588)4213128-5 gnd
Pharmakotherapie (DE-588)4076066-2 gnd
topic_facet Poumons - Maladies obstructives - Chimiothérapie
Drug Evaluation
Lungs Diseases, Obstructive Chemotherapy
Pulmonary Disease, Chronic Obstructive drug therapy
Obstruktive Ventilationsstörung
Pharmakotherapie
Aufsatzsammlung
url http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=010725767&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA
volume_link (DE-604)BV000008326
work_keys_str_mv AT cellibartolomer pharmacotherapyinchronicobstructivepulmonarydisease