Navegando por Palavras-chave "Bronchodilator agents"
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- ItemSomente MetadadadosCan bronchodilators improve exercise tolerance in COPD patients without dynamic hyperinflation?(Soc Brasileira Pneumologia Tisiologia, 2014-03-01) Scuarcialupi, Maria Enedina Aquino; Berton, Danilo Cortozi; Cordoni, Priscila Kessar; Squassoni, Selma Denis; Fiss, Elie; Neder, Jose Alberto [UNIFESP]; Fac Ciencias Med Paraiba; Univ Fed Rio Grande do Sul; Fac Med ABC; Queens Univ; Kingston Gen Hosp; Universidade Federal de São Paulo (UNIFESP)Objective: To investigate the modulatory effects that dynamic hyperinflation (UFO, defined as a reduction in inspiratory capacity (lC), has on exercise tolerance after bronchodilator in patients with COPD. Methods: An experimental, randomized study involving 30 COPD patients without severe hypoxemia. At baseline, the patients underwent clinical assessment, spirometry, and incremental cardiopulmonary exercise testing (CPET). On two subsequent visits, the patients were randomized to receive a combination of inhaled fenoterol/ipratropium or placebo. All patients then underwent spirometiy and submaximal CPET at constant speed up to the limit of tolerance (Tlim). The patients who showed Delta lC(peak-rest) < 0 were considered to present with DH (DH+). Results: In this sample, 21 patients (70%) had DH. The DH+ patients had higher airflow obstruction and lower Tlim than did the patients without Did (DH-). Despite equivalent improvement in FEV1 after bronchodilator, the DH- group showed higher Delta lC(bronchodilator-placebo) at rest in relation to the DH+ group (p < 0.05). However, this was not found in relation to Delta lC at peak exercise between DH+ and DH- groups (0.19 +/- 0.17 L vs. 0.17 +/- 0.15 L, p > 0.05). in addition, both groups showed similar improvements in Tlim after bronchodilator (median [interquartile range]: 22% [3-60% vs. 10% [3-53%]; p > 0.05). Conclusions: Improvement in TLim was associated with an increase in lC at rest after bronchodilator in HD- patients with COPD. However, even without that improvement, COPD patients can present with greater exercise tolerance after bronchodilator provided that they develop DH during exercise.
- ItemAcesso aberto (Open Access)Efeito da teofilina associada ao beta2-agonista inalatório de curta ou longa duração, em pacientes com doença pulmonar obstrutiva crônica estável: revisão sistemática(Sociedade Brasileira de Pneumologia e Tisiologia, 2007-04-01) Zacarias, Eliane Cristina [UNIFESP]; Castro, Aldemar Araujo [UNIFESP]; Cendon Filha, Sônia Perez [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVES: To determine whether, in stable patients with chronic obstructive pulmonary disease, administration of theophylline in combination with short-acting or long-acting inhaled beta2-agonists is more efficacious than is a placebo or each of these drugs used in isolation. METHODS: A systematic review and meta-analysis were carried out. All randomized and double-blind clinical trials found in the literature were selected. RESULTS: A total of eight studies were included. In comparing the effect of theophylline combined with beta2-agonists to that of a placebo, we found a statistically significant improvement in mean FEV1 (0.27 L; 95%CI: 0.11 to 0.43) and mean dyspnea (-0.78; 95%CI: -1.26 to -0.29). None of the meta-analyses performed detected any difference between the results obtained using theophylline combined with beta2-agonists and those obtained using beta2-agonists alone. When the administration of theophylline combined with beta2-agonists was compared to that of theophylline alone, there was a statistically significant improvement in mean dyspnea (-0.19; 95%CI: -0.34 to 0.04). CONCLUSION: In patients with stable chronic obstructive pulmonary disease, theophylline combined with beta2 agonists is more efficacious than is a placebo in terms of improving FEV1 and dyspnea. In addition, theophylline combined with beta2 agonists is more efficacious than is theophylline in improving dyspnea. Furthermore, administration of theophylline combined with beta2 agonists is no more efficacious, for any of the variables studied, than is the use of beta2-agonists in isolation.
- ItemSomente MetadadadosEfeito da teofilina associada aos beta-2 agonistas inalatórios de curta e longa duração, em pacientes estáveis com doença pulmonar obstrutiva crônica(Universidade Federal de São Paulo (UNIFESP), 2003) Zacarias, Eliane Cristina [UNIFESP]; Cendon, Sônia [UNIFESP]Contexto: A doenca pulmonar obstrutiva cronica (DPOC) e uma doenca progressiva e caracterizada pela limitacao ao fluxo aereo, nao totalmente reversivel. O uso de broncodilatadores e considerado o tratamento de primeira escolha para o controle dos sintomas da DPOC, sendo os 02 agonistas e os anticolinergicos inalatorios, juntamente com a teofilina os mais utilizados. A teofilina tem sido usada no tratamento da DPOC por melhorar a funcao pulmonar, diminuir sintomas e aumentar a forca da musculatura respiratoria. Os (i2 agonistas melhoram a funcao pulmonar, reduzem a dispneia e os sintomas. A combinacao de drogas com tempo de acao e mecanismos diferentes pode melhorar a resposta aos broncodilatadores, com diminuicao dos efeitos adversos. Objetivos: Avaliar se o tratamento com teofilina associada aos 02 agonistas de curta e longa duracao e mais eficaz que o placebo e que o uso isolado de cada uma das drogas, para os pacientes estaveis com DPOC. Tipo de estudo: Revisao sistematica de estudos clinicos aleatorios com metanalise. Local: Disciplina de Pneumologia do Departamento de Medicina da Universidade Federal de São Paulo - Escola Paulista de Medicina, São Paulo - Brasil. Estrategia de busca: As fontes de estudos utilizadas (onde nao havia restricoes concernentes a data, idioma ou quaisquer outras) foram: EMBASE, LILACS, MEDLINE, a base de dados de ensaios clinicos controlados da Colaboracao Cochrane, o registro de ensaios controlados aleatorios do grupo de vias aereas da Colaboracao Cochrane e a lista de referencias dos ensaios clinicos aleatorios encontrados. Selecao: dois revisores independentes, avaliando os criterios de inclusao e exclusao
- ItemAcesso aberto (Open Access)Equivalência farmacêutica da formulação combinada de budesonida e formoterol em cápsula única com dispositivo inalador de pó(Sociedade Brasileira de Pneumologia e Tisiologia, 2012-12-01) Andrade-lima, Marina; Pereira, Luiz Fernando Ferreira; Fernandes, Ana Luisa Godoy [UNIFESP]; Hospital Pró-Cardíaco; Universidade Federal de Minas Gerais Hospital das Clínicas Ambulatório de Cessação do Tabagismo Residência de Pneumologia; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To evaluate the pharmaceutical equivalence of a test formulation (fixed-dose combination of budesonide and formoterol fumarate in a single capsule dispensed in an Aerocaps® inhaler) in relation to a reference formulation (budesonide and formoterol fumarate in two separate capsules dispensed in an Aerolizer® inhaler). METHODS: This was an in vitro study in which we performed the identification/quantification of the active ingredients by HPLC and determined dose uniformity and aerodynamic particle size distribution in the test and reference formulations. RESULTS: In the test formulation, the content of budesonide and formoterol was 111.0% and 103.8%, respectively, compared with 110.5% and 104.5%, respectively, in the reference formulation. In the test formulation, dose uniformity regarding budesonide and formoterol was 293.2 µg and 10.2 µg, respectively, whereas it was 353.0 µg and 11.1 µg in the reference formulation. These values are within the recommended range for this type of formulation (75-125% of the labeled dose). The fine particle fraction (< 5 µm) for budesonide and formoterol was 45% and 56%, respectively, in the test formulation and 54% and 52%, respectively, in the reference formulation. CONCLUSIONS: For both of the formulations tested, the levels of active ingredients, dose uniformity, and aerodynamic diameters were suitable for use with the respective dry powder inhalers.
- ItemSomente MetadadadosPontos de corte da resposta ao broncodilatador e valores de referência para VEF 0,75 em espirometria de pré-escolares(Soc Brasileira Pneumologia Tisiologia, 2016) Burity, Edjane Figueiredo; de Castro Pereira, Carlos Alberto [UNIFESP]; Jones, Marcus Herbert; Sayao, Larissa Bouwman; de Andrade, Armele Dornelas; Amorim de Britto, Murilo CarlosObjective: To determine the cut-off points for FEV1, FEV0.75, FEV0.5, and FEF25-75% bronchodilator responses in healthy preschool children and to generate reference values for FEV0.75. Methods: This was a cross-sectional community-based study involving children 3-5 years of age. Healthy preschool children were selected by a standardized questionnaire. Spirometry was performed before and after bronchodilator use. The cut-off point of the response was defined as the 95th percentile of the change in each parameter. Results: We recruited 266 children, 160 (60%) of whom were able to perform acceptable, reproducible expiratory maneuvers before and after bronchodilator use. The mean age and height were 57.78 ± 7.86 months and 106.56 ± 6.43 cm, respectively. The success rate for FEV0.5 was 35%, 68%, and 70% in the 3-, 4-, and 5-year-olds, respectively. The 95th percentile of the change in the percentage of the predicted value in response to bronchodilator use was 11.6%, 16.0%, 8.5%, and 35.5% for FEV1, FEV0.75, FEV0.5, and FEF25-75%, respectively. Conclusions: Our results provide cut-off points for bronchodilator responsiveness for FEV1, FEV0.75, FEV0.5, and FEF25-75% in healthy preschool children. In addition, we proposed gender-specific reference equations for FEV0.75. Our findings could improve the physiological assessment of respiratory function in preschool children.