MedWorm: Albuterol

  DUONEB (Ipratropium Bromide And Albuterol Sulfate) Solution [Dey, LP]

Updated Date: Mar 11, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  VENTOLIN (Albuterol Sulfate) Aerosol, Metered [Dispensing Solutions Inc.]

Updated Date: Mar 3, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Learning From the Past. What is Chlorosis?

Discussion In practicing medicine, clinicians try to provide the best care for the patients and families they serve. They usually try to use the most current information available and apply it to the specific patient situation, yet medicine is an ever-changing science and art. Disease theories change. For example, mental illness was once thought to be caused by the lunar cycles thus the name “lunacy” or “lunatic.” Overtime it became known that neurochemical and genetic factors play a role. Scientific information is re-analyzed or classified. For example, the organism that causes cat-scratch disease has had 3 names since 1991 - Afipis felis, Rochlimacae henselae, and currently Bartonella henselae. Disease treatments are often changing as new information becomes avail...

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  PROAIR (Albuterol Sulfate) Aerosol, Metered [Teva Specialty Pharmaceuticals LLC ]

Updated Date: Feb 24, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Comparative Effects of Caffeine and Albuterol on the Bronchoconstrictor Response to Exercise in Asthmatic Athletes

Int J Sports MedDOI: 10.1055/s-0030-1247592AbstractThe main aim of this study was to evaluate the comparative and additive effects of caffeine and albuterol (short-acting β-agonist) on the severity of EIB. Ten asthmatic subjects with EIB (exercise-induced bronchoconstriction) participated in a randomized, double-blind, double-dummy crossover study. One hour before an exercise challenge, each subject was given 0, 3, 6, or 9 mg/kg of caffeine or placebo mixed in a flavored sugar drink. Fifteen minutes before the exercise bout, an inhaler containing either albuterol (180 μg) or placebo was administered to each subject. Pulmonary function tests were conducted pre- and post-exercise. Caffeine at a dose of 6 and 9 mg/kg significantly reduced (p<0.05) the mean maxim...

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  Doctors Need More Freedom Of Choice In Rescue Asthma Therapy

A recent electronic survey of US asthma experts demonstrated the need for better access to levalbuterol, the fast-acting medicine used to treat the narrowing of airways (bronchospasm) caused by asthma, for selected patients. 100% of the doctors surveyed reported that some of their patients suffer "annoying" side-effects, such as hyperactivity and jitteriness with a similar and more commonly prescribed drug - albuterol... (Source: Health News from Medical News Today)

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  Death by aphrodisiac

This is another case from the 2008 report of the National Poison Data System (NPDS). Case 959: A 35-year-old man reportedly ingested one pill of a product labelled “piedra”, purported to be an aphrodisiac. Several hours later he was brought to the emergency department with pain in his chest and abdomen.  In the field he received atropine for bradycardia and hypotension, with good response. Workup revealed a measured digoxin level of 2.9 mcg/mL and potassium of 7.  His EKG showed narrow complexes with variable AV block.  On the second hospital day he ventricular fibrillation from which he could not be resuscitated.  Treatment up to that time included insulin, glucose, bicarbonate, albuterol, atropine, and a total of 35 vials of Digibind. Unfortunately, the information provid...

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  Effect of face mask dead volume, respiratory rate, and tidal volume on inhaled albuterol delivery

Pediatric patients often require metered-dose inhaler (MDI) with holding chamber (HC) to overcome lack of coordination when receiving inhaled therapy. In infants and young children unable to use a mouthpiece, it is necessary to use a mask interface. We compared the effect of varying mask static dead volume (SDV), respiratory rate (RR), and tidal volume (VT) on albuterol captured at the mouth opening (ACMO) in an in vitro model.An Aerochamber Max® without and with three mask sizes (SDV of 10, 36, 85, and 200 ml, respectively) was connected in series to a filter holder and breathing simulator. ACMO was measured at VTs = 36, 72, 145, and 290 ml and RR of 12 and 24. Each experiment comprised 10 puffs run for six respiratory cycles each. Albuterol was quantified via spectrophotometry at 276 nm...

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  ALBUTEROL SULFATEsolution [Hi-Tech Pharmacal Co., Inc.]

Updated Date: Feb 4, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Symposium on the Future of Therapeutics Inaugurates New UCSF Department

February 3, 2010In the first symposium held by the newly minted UCSF Department of Bioengineering and Therapeutic Sciences, researchers described progress in the fields of systems biology, pharmacogenomics, and bioengineering, and how scientists in these fields are working in concert to develop novel diagnostics and therapeutics to effectively and safely diagnose and treat disease. The conference, Picking up the Pace of Therapeutics Research and Application, was held January 26, 2010 at the William J. Rutter Center on the UCSF Mission Bay Campus. Strategies shared included the targeted delivery of therapeutics with nano- and micro-technologies, drug design aimed at biological networks rather than any one metabolic step, and the engineering of cheap but sturdy medical devices to help pati...

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  ALBUTEROL SULFATEsolution [Mylan Pharmaceuticals Inc.]

Updated Date: Feb 3, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  PROAIR (Albuterol Sulfate) Aerosol, Metered [Teva Specialty Pharmaceuticals LLC ]

Updated Date: Feb 2, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  ALBUTEROL SULFATEsolution [Mylan Pharmaceuticals Inc.]

Updated Date: Feb 2, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  What Causes Respiratory Distress?

Discussion Pectus excavatum is a deformation of the chest wall where the sternum and ribs grow abnormally to form a concavity relative to normal positioning. Pectus carnitum is similar but forms a convexity. Pectus excavatum is much more common (90%) than pectus carnitum (7-8%) or other congenital chest wall deformities (2-3%). Pectus excavatum is usually noted at birth or in the first year of life. It may be relatively minor (the most common) or quite severe (rarer) with the concavity displacing internal organs and possibly causing pulmonary and/or cardiac abnormalities. Usually it is relatively stable, but may progress especially during times of rapid growth such as puberty. Thankfully most patients do not need treatment but severe pectus excavatum may cause psychological distress becaus...

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  ALBUTEROL SULFATEsolution [Nephron Pharmaceuticals Corporation]

Updated Date: Jan 22, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  ALBUTEROL SULFATEsolution [Nephron Pharmaceuticals Corporation]

Updated Date: Jan 22, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  ALBUTEROL SULFATEsolution [Nephron Pharmaceuticals Corporation]

Updated Date: Jan 22, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Asthma in adults

New evidence; conclusions changed for: Education about acute asthma One systematic review (search date 2006) added comparing education versus usual care in adults who had attended an emergency department for asthma exacerbation. It found that education reduced hospital admissions compared with usual care, but it found no significant difference in subsequent presentations to emergency departments, primary care physician urgent visits, primary care physician call outs, quality of life, physical limitations caused by asthma, or lung function, between education and control. Evidence added at update does not support evidence previously reported on effects of education about asthma. Considering evidence added at update, categorisation changed from "Beneficial" to "Unkno...

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  A pilot study to compare natural health product–drug interactions in two databases in Canada

Conclusion This pilot study presents a comparison of potential natural health product–drug interactions from two different databases using two different scenarios in a hospital setting. The study reveals a high and variable number of pairs of natural health product–drug interactions per drug between the NSD and the NMCD. Further studies are necessary to evaluate the pertinence and hierarchy of the information offered by suppliers and natural health product databases. Content Type Journal ArticleCategory Research ArticleDOI 10.1007/s11096-010-9364-2Authors Guillaume Faubert, CHU Sainte-Justine Pharmacy Department, Pharmaceutical Practice Research Unit (PPRU) 3175, Chemin de la Côte-Ste-Catherine Montreal QC H3T 1C5 CanadaDenis Lebel, CHU Sainte-Justine Pharmacy Department, Phar...

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  An elevated bronchodilator response predicts large airway inflammation in mild asthma

Exhaled nitric oxide (eNO) is elevated in asthmatics and is a purported marker of airway inflammation. The bronchodilator response (BDR) has also been shown to correlate with markers of airway inflammation, including eNO at 50 ml/sec (FENO,50) which is comprised of NO from both the proximal and distal airways. Using eNO at multiple flows and a two-compartment model of NO exchange, the eNO signal can be partitioned into its proximal [J'awNO (nl/sec)] and distal contributions [CANO (ppb)]. We hypothesized that the BDR reflects the inflammatory status of the larger airways with smooth muscle, and thus would correlate with J'awNO. In 179 predominantly (95%) Hispanic children with mild asthma (69 steroid naïve), and 21 non-asthmatic non-atopic controls, spirometry and eNO at multiple flows wer...

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  PROAIR (Albuterol Sulfate) Aerosol, Metered [Teva Specialty Pharmaceuticals LLC ]

Updated Date: Jan 11, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  An Unusual Dermatosis in a Child

A 9-year-old boy presented to the emergency room with various macular erythematoses and ecchymotic lesions with geometric shapes and well-defined edges on his left hand and forearm (). Initially, the child denied that the lesions were self-inflicted. But during the anamnesis, his grandmother mentioned that she had noticed that her albuterol inhaler had run out before she had expected. We confirmed that the shape of the distal part of the inhaler corresponded exactly with the borders of the child's skin lesions. Finally, the child confessed that he had created the lesions by heating the inhaler on a vitroceramic hotplate and then applying it to his skin. (Source: The Journal of Pediatrics)

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  albuterol, Ventolin, Proventil, Proventil-HFA, AccuNeb, Vospire, ProAir

Title: albuterol, Ventolin, Proventil, Proventil-HFA, AccuNeb, Vospire, ProAirCategory: MedicationsCreated: 12/31/1997Last Editorial Review: 1/7/2010 (Source: MedicineNet Medications General)

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  albuterol, Ventolin, Proventil, Proventil-HFA, AccuNeb, Vospire, ProAir

Title: albuterol, Ventolin, Proventil, Proventil-HFA, AccuNeb, Vospire, ProAirCategory: MedicationsCreated: 12/31/1997Last Editorial Review: 1/7/2010 (Source: MedicineNet Asthma General)

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  albuterol, Ventolin, Proventil, Proventil-HFA, AccuNeb, Vospire, ProAir

Title: albuterol, Ventolin, Proventil, Proventil-HFA, AccuNeb, Vospire, ProAirCategory: MedicationsCreated: 12/31/1997Last Editorial Review: 1/7/2010 (Source: MedicineNet Lungs General)

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  VENTOLIN (Albuterol Sulfate) Aerosol, Metered [GlaxoSmithKline LLC]

Updated Date: Jan 7, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Metabolic Testing Rates in 3 State Medicaid Programs After FDA Warnings and ADA/APA Recommendations for Second-Generation Antipsychotic Drugs [Original Article]

Conclusions  In a Medicaid-receiving population, baseline glucose and lipid testing for SGA-treated patients was infrequent and showed little change following the diabetes warning and monitoring recommendations. A change in SGA drug selection consistent with intentions to reduce metabolic risk was observed. (Source: Archives of General Psychiatry)

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  IPRATROPIUM BROMIDE AND ALBUTEROL SULFATEsolution [Sandoz Inc.]

Updated Date: Dec 23, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  VENTOLINHFA (Albuterol Sulfate) Aerosol, Metered [Rebel Distributors Corp.]

Updated Date: Dec 22, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Decreased platelet nitric oxide contributes to increased circulating monocyte-platelet aggregates in hypertension

Conclusion Platelet NO production and responsiveness are suppressed with raised BP, and this may contribute to the increase in platelet P-selectin and hence in circulating MPA in hypertension. (Source: European Heart Journal)

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  ALBUTEROL SULFATEsolution [Mylan Pharmaceuticals Inc.]

Updated Date: Dec 9, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Metformin Reduces Arterial Stiffness and Improves Endothelial Function in Young Women with Polycystic Ovary Syndrome: A Randomized, Placebo-Controlled, Crossover Trial.

Conclusions: Short-term metformin therapy improves arterial stiffness and endothelial function in young women with PCOS. PMID: 19996308 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)

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  Nebulized formoterol provides added benefits to tiotropium treatment in chronic obstructive pulmonary disease.

CONCLUSIONS: The addition of FFIS to maintenance TIO treatment for moderate to severe COPD results in significantly improved FEV(1) and dyspnea, decreased rescue medication use, and a lower incidence of AEs and COPD exacerbations. The addition of FFIS to TIO yields clinically and statistically significant benefits for COPD patients and might be of long-term benefit. PMID: 19953349 [PubMed - as supplied by publisher] (Source: Advances in Therapy)

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  Continuous Levalbuterol and Albuterol Comparable

(Source: AAP Grand Rounds)

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  Detection and home management of worsening asthma symptoms.

CONCLUSIONS: Although parents described antecedent symptoms and signs of impending asthma exacerbations that they consistently noticed in their children, many waited for lower respiratory signs to be present before intensifying treatment. Oral corticosteroids were used infrequently. Interventions to improve the ability of parents and children to accurately recognize worsening symptoms and initiate timely, effective treatment are needed. PMID: 20084839 [PubMed - in process] (Source: Annals of Allergy, Asthma and Immunology)

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  The effect of statin therapy on allergic patients with asthma.

CONCLUSIONS: This preliminary study demonstrated that patients with asthma who received statins had a worse clinical course than controls. Given the prevalence of both statin use and asthma, further research is needed. PMID: 20084838 [PubMed - in process] (Source: Annals of Allergy, Asthma and Immunology)

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  ALBUTEROL SULFATEtablet [Mutual Pharmaceutical Company, Inc.]

Updated Date: Nov 30, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  ALBUTEROL SULFATEsolution [Watson Laboratories, Inc.]

Updated Date: Nov 23, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  VENTOLINHFA (Albuterol Sulfate) Aerosol, Metered [Physicians Total Care, Inc.]

Updated Date: Nov 19, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Beta2-Receptor Polymorphisms in Patients Receiving Salmeterol with or without Fluticasone Propionate.

CONCLUSIONS: The results showed no evidence of a pharmacogenetic effect of beta-receptor variation on salmeterol response. Clinical Trials Registry information available at www.clinicaltrials.gov, i.d. NCT00102882. PMID: 19910613 [PubMed - as supplied by publisher] (Source: American Journal of Respiratory and Critical Care Medicine)

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  CHEST: Lower Doses Benefit Pediatric Asthma Patients

In children who are hospitalized with asthma, a reduced-dose steroid regimen has no effect on hospital stays, and low-dose albuterol treatment is associated with a lower risk of metabolic acidosis than high-dose treatment, according to research presented at the 75th annual international scientific assembly of the American College of Chest Physicians, held from Oct. 31 to Nov. 5 in San Diego. (Source: Modern Medicine)

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  Impact of a Household Environmental Intervention Delivered by Lay Health Workers on Asthma Symptom Control in Urban, Disadvantaged Children With Asthma.

CONCLUSIONS: Lay health educators effectively reduced asthma triggers and increased caregiver asthma knowledge, which resulted in reduced emergency department visits, hospitalizations, and asthma symptoms. The relationships formed between the caregivers and the lay health educators appeared to positively impact asthma outcomes in this disadvantaged population. PMID: 19890172 [PubMed - as supplied by publisher] (Source: American Journal of Public Health)

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  Dysphagia associated with an elevated amylase level

A 34-year-old woman with a history of gastric ulcers, GERD, and asthma presented for endoscopic evaluation of recurrent dyspepsia and 2 months of dysphagia for solids. She denied odynophagia, weight loss, early satiety, and fever. Her medications included omeprazole and albuterol. Physical examination was unremarkable. Laboratory data were pertinent only for a mildly elevated serum amylase levels of 212 U/L and 180 U/L (normal range 30-110 U/L) with normal lipase levels on consecutive phlebotomies. An EGD revealed extrinsic compression of the distal esophagus (A) and a clean-based antral ulcer; testing for Helicobacter pylori was negative. A CT scan of the chest documented a 3.5 × 2.0-cm, rounded, smooth-walled soft tissue mass in the anterior border of the distal esophagus (B). An EUS re...

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  Counterregulation of β2-adrenoceptor function in human mast cells by stem cell factor

Conclusion: The potentially beneficial effects of β2-adrenoceptor agonists in asthmatic airways may be blunted as a result of the high concentrations of SCF present. (Source: Journal of Allergy and Clinical Immunology)

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  COMBIVENT (Ipratropium Bromide And Albuterol Sulfate) Aerosol, Metered [Boehringer Ingelheim Pharmaceuticals, Inc.]

Updated Date: Oct 23, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  IPRATROPIUM BROMIDE AND ALBUTEROL SULFATEsolution [Mylan Pharmaceuticals Inc.]

Updated Date: Oct 14, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Central and peripheral airway sites of nitric oxide gas exchange in copd.

CONCLUSION: In COPD, there was normal NO gas exchange in both large and small airways/alveoli and only large airway NO flux was suppressed with F250/S50 but not F100/S50 despite varying extent of emphysema. Peripheral NO must be corrected for axial NO backdiffusion to avoid spurious conclusions. NCT#00568347. PMID: 19820080 [PubMed - as supplied by publisher] (Source: Chest)

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  Child asthma pumps questioned

This study is of value given the high prevalence of asthma and the universal use of bronchodilators in the management of asthma. These inhaled drugs are initially prescribed for use only when asthma becomes bad (i.e. as-required prescription rather than regular use), but if the condition is not controlled, secondly inhaled corticosteroids and thirdly, longer-acting bronchodilators may be prescribed. Given the widespread use of bronchodilators by both adults and children, reports on this study might potentially cause some alarm. While this concern is understandable, this is initial research and  short-acting inhalers are still the best treatments for asthma attacks. As one of the lead authors of the study, Professor Mukhopadhyay, has emphasised, “Do not stop using your inhaler or change...

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  Adrenergic β2-receptor genotype predisposes to exacerbations in steroid-treated asthmatic patients taking frequent albuterol or salmeterol

Conclusion: The Arg16 genotype of ADRB2 is associated with exacerbations in asthmatic children and young adults exposed daily to β2-agonists, regardless of whether the exposure is to albuterol or long-acting agonists, such as salmeterol. (Source: Journal of Allergy and Clinical Immunology)

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  Burden of chronic obstructive pulmonary disease in medicare beneficiaries residing in long-term care facilities.

Conclusion: This study found that the utilization of health care resources and economic burden of LTC residents with COPD were primarily due to LTC, pharmacy, and inpatient costs. PMID: 19948302 [PubMed - in process] (Source: The American Journal of Geriatric Pharmacotherapy)

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  Influence of moisture accumulation in inline spacer on delivery of aerosol using metered-dose inhaler during mechanical ventilation.

CONCLUSIONS: Aerosol delivery from a pMDI with spacer during mechanical ventilation was greater with a dry spacer and unchanged for the first hour after initiating heated humidification. Turning off the heated humidifier did not increase drug delivered. PMID: 19796413 [PubMed - in process] (Source: Respiratory Care)

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  Fibromuscular dysplasia of ostial left main coronary artery depicted by intravascular ultrasound

A 32-year-old woman with no known cardiac risk factors was admitted at 12 weeks' gestation with exertional chest pain and shortness of breath. Four months prior, she noted severe exertional left-sided chest pressure. Her primary care physician had prescribed omeprazole and albuterol which did not improve her symptoms. One week prior, she developed left-sided chest pain radiating to the left arm which lasted for 20 min. An ECG obtained at the office visit that day was unremarkable. She was referred to our center for a stress echocardiogram. The treadmill stress test was stopped at 3 min after she developed chest pain. The ECG revealed 2- to 3-mm horizontal ST depressions in leads II, III, aVF, and V3–V6 (). The stress echocardiogram showed severe hypokinesis of the anterior and lateral wa...

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  Attacking Asthma: Five steps to treat pediatric status asthmaticus

EMS is called to the house of a 12-year-old male patient in severe respiratory distress. He has a history of asthma and is on multiple controller medicines, including Flovent, Singulair and albuterol sulfate. On arrival to the house, you find the patient seated in a tripod position. He's tachypneic and in severe distress. His mother states he developed cold symptoms yesterday and has used his albuterol inhaler multiple times today without improvement. (Source: JEMS: Journal of Emergency Medical Services)

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  Hydrofluoroalkane mandate in effect January 1, 2009: Switch from chlorofluorocarbon- to hydrofluoroalkane-propelled inhalers requires active transition.

Authors: Peters S The manufacture, sale, and distribution of chlorofluorocarbon-propelled albuterol metered-dose inhalers ceased as of December 31, 2008. Clinicians should actively transition patients to currently available hydrofluoroalkane-propelled devices, providing concise education and instruction for using the newer devices. PMID: 19781516 [PubMed - in process] (Source: Clinical Cornerstone)

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  Proventil HFA (Albuterol Inhalation) - updated on RxList

Proventil HFA (Albuterol Inhalation) drug description - FDA approved labeling for prescription drugs and medications at RxList (Source: RxList - New and Updated Drug Monographs)

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  FDA Warns Consumers Not to Use Stolen Albuterol Sulfate Inhalation Solution and Ipratropium Bromide Inhalation Solution

Source: Food and Drug Administration Related MedlinePlus Topic: Drug Safety (Source: MedlinePlus Health News)

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  FDA Warns Consumers Not To Use Stolen Albuterol Sulfate Inhalation Solution And Ipratropium Bromide Inhalation Solution

The U.S. Food and Drug Administration advised consumers not to use certain respiratory medications purchased after Sept. 8, 2009 and manufactured by Dey L.P., a subsidiary of Mylan Inc., because the medications might have been part of a shipment being transported on a tractor-trailer stolen in Tampa, Fla., on Sept. 8, 2009. The respiratory medications, Ipratropium Bromide Inhalation Solution, 0. (Source: Health News from Medical News Today)

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  FDA Says to Avoid Stolen Albuterol Sulfate, Ipratropium Bromide

(Source: Physician's First Watch current issue)

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  FDA Warns Consumers Not to Use Stolen Albuterol Sulfate Inhalation Solution and Ipratropium Bromide Inhalation Solution

The U.S. Food and Drug Administration today advised consumers not to use certain respiratory medications purchased after Sept. 8, 2009 and manufactured by Dey L.P., a subsidiary of Mylan Inc., because the medications might have been part of a shipment being transported on a tractor-trailer stolen in Tampa, Fla., on Sept. 8, 2009. (Source: Food and Drug Administration)

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  Albuterol Sulfate Inhalation Solution unit-dose vials (Dey LP brand)

Two lots (35,760 cartons) stolen in Texas. Pharmacies encouraged to verify pedigree documentation for all purchases of Dey-labeled Albuterol. (Source: FDA MedWatch)

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  Albuterol Sulfate Inhalation Solution unit-dose vials (Dey LP brand)

Audience: Pharmacists and pharmacy organizations [Posted 09/10/2009] FDA notified pharmacists that two complete Lots (9FE2 and 9G01) containing 35,760 cartons of Albuterol Sulfate Inhalation Solution, 0.083%, unit-dose vials was stolen in Texas... (Source: Drugs.com - FDA MedWatch Alerts)

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  Pharmacotherapy in pediatric critical illness: a prospective observational study.

Authors: McDonnell C, Hum S, Frndova H, Parshuram CS Pharmacotherapy is an under-evaluated element of critical care medicine. In order to better understand pharmacotherapy in pediatric critical illness, we evaluated a cohort of emergency admissions to a university-affiliated pediatric intensive care unit (PICU). A prospective, observational study was performed. Eligible patients were admitted to this medical-surgical ICU for at least 24 hours. The primary outcomes were the number of drug orders written, the number of different medications ordered, and the number of drug administrations. Multiple regression analyses were used to identify factors independently associated with each primary outcome. We studied 100 patients with a median age of 40 months (interquartile range [IQR] 9-82), wh...

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  VENTOLIN (Albuterol Sulfate) Aerosol, Metered [SmithKline Beecham Corporation]

Updated Date: Sep 1, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Pulmonary dysanapsis and diving assessments.

This report highlights pulmonary dysanapsis which may be confused with obstructive airway disease and applicants deemed unfit to dive. While pulmonary dysanapsis may increase the risk of airway hyperresponsiveness, there is no evidence of an association with diving-related pulmonary barotrauma. PMID: 20112528 [PubMed - indexed for MEDLINE] (Source: Undersea and Hyperbaric Medicine)

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  Transition to Albuterol HFA: Are All Inhalers Interchangeable?

Abstract: The prevalence of asthma in the United States is on the rise, and current asthma guidelines recommend prescribing short-acting beta agonists (albuterol) for treatment of reversible airway disease. Government regulations have imposed the transition from albuterol CFC (chlorofluorocarbon) to albuterol HFA (hydrofluroalkane). Prescribers must consider differences between CFC versus HFA inhalers, as well as variations among the available forms of albuterol HFA. Device design, increased cost for branded medication, patient preference, and a host of variables must be considered when deciding among the types of albuterol HFA for a given patient. Pharmacists and clinicians must partner together and recognize that all forms of albuterol are not interchangeable and thus improve asthma...

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  Measuring the Assessment and Counseling Provided with the Supply of Nonprescription Asthma Reliever Medication: A Simulated Patient Study (September).

CONCLUSIONS: Both patient assessment and medication counseling were suboptimal compared with recommended practice when nonprescription asthma reliever medication was supplied in the community pharmacy setting. Pharmacy and pharmacist demographic variables do not appear to affect assessment of asthma control. This research indicates the need for substantial improvements in practice in order to provide reliever medication in line with Quality Use of Medication principles of ensuring safe and effective use of medication. PMID: 19690228 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)

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  Warning on Stolen Albuterol Sulfate Inhalation Solution and Ipratropium Bromide Inhalation Solution

FDA is advising consumers not to use certain respiratory medications purchased after Sept. 8, 2009 and manufactured by Dey L.P., a subsidiary of Mylan Inc., because the medications might have been part of a shipment being transported on a tractor-trailer stolen in Tampa, Fla., on Sept. 8, 2009. (Source: FDA Consumer Updates)

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  Levalbuterol versus albuterol

Abstract  Albuterol has been used for more than 40 years to treat acute asthma exacerbations as a racemic mixture of isomers: the active form, (R)-albuterol, or levalbuterol, and (S)-albuterol, classically considered inert. The single-isomer formulation, levalbuterol, has been synthesized recently and used therapeutically when the racemate is deemed less desirable. Basic investigations indicate that racemic albuterol and levalbuterol can produce effects that favor asthma remediation, including corticosteroid amplification and reduction of inflammatory mediators; in contrast, (S)-albuterol produces opposite effects. With inhalation of racemic albuterol, circulating (S)-albuterol persists 12 times longer than levalbuterol, suggesting potential for paradoxical effects observed...

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  Effects of airway obstruction on albuterol-mediated variations in the resistive and elastic properties of the respiratory system of patients with asthma

CONCLUSIONS: In patients with asthma, increased airway obstruction results in greater reductions in R0 and Edyn after albuterol use. These reductions are greater among BR+ patients than among BR- patients. (Source: Jornal Brasileiro de Pneumologia)

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  G.P.9.01 Albuterol promotes sustained improvement in motor function in spinal muscular atrophy type III

Conclusions: These 4 SMA-III patients had a variable but sustained response to oral albuterol treatment, most notably in improved ambulation. These observations may warrant a formal treatment trial. (Source: Neuromuscular Disorders)

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  VENTOLIN (Albuterol Sulfate) Aerosol, Metered [SmithKline Beecham Corporation]

Updated Date: Aug 3, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Bronchodilator effects of exercise hyperpnea and albuterol in mild-to-moderate asthma

In conclusion, in mild-to-moderate asthmatic individuals, hyperpnea at peak exercise was associated with a potent yet not complete bronchodilatation. During constant-load exercise, a transient bronchodilatation was followed by airway renarrowing, suggesting prevalence of constrictor over dilator effects of hyperpnea. Finally, the bronchodilator effect of hyperpnea was additive to that of albuterol. (Source: Journal of Applied Physiology)

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  Medication Use Among Children

CONCLUSIONS: The majority of US children <12 years of age use ≥1 medication product in a given week. The preponderance of pediatric medication exposure involves over-the-counter products. (Source: PEDIATRICS)

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  Evaluation of high-dose continuous nebulized levalbuterol

In this issue of The Journal, Andrews et al from the University of Pennsylvania compared high-dose continuous levalbuterol to high-dose continuous racemic albuterol using equipotent doses in 81 children attending the emergency department with acute exacerbations of asthma. The adverse effects and the outcomes were similar in the two groups. Both groups were weaned from continuous bronchodilator therapy in 16-18 hours but no advantage was demonstrated for levalbuterol. It is notable that there was pharmaceutical company support for this study, although in the end the results did not benefit the company. (Source: The Journal of Pediatrics)

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  Asthma morbidity among inner-city adolescents receiving guidelines-based therapy: Role of predictors in the setting of high adherence

Conclusion: Our findings demonstrate that the usual predictors of future disease activity have little predictive power when applied to a highly adherent population with persistent asthma that is receiving guidelines-based care. Thus, new predictors need to be identified that will be able to measure the continued fluctuation of disease that persists in highly adherent, well-treated populations such as the one studied. (Source: Journal of Allergy and Clinical Immunology)

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  The effects of racemic albuterol versus levalbuterol in very low birth weight infants

Bronchodilators have been used in premature infants. Levalbuterol (LEV) an R-isomer of Albuterol has fewer hemodynamic side effects than Racemic Albuterol (RAC) in adults and children. In a retrospective study we sought to investigate the effects of LEV (0.31 mg) versus RAC (1.25 mg) in very low-birth weight infants (VLBW) who were treated with a beta-2 agonist for [ge]2 weeks. Medical records (between January 2001 and December 2006) were reviewed for patients' demographics, medications use, hemodynamic and respiratory parameters, hypokalemia and hyperglycemia. Among 811 VLBW infants who were admitted to our NICU, 16 infants received RAC and 31 infants received LEV for [ge]2 weeks. Infants who received RAC were younger, smaller, and received less Ipratropium Bromide (IB) than infants who r...

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  IPRATROPIUM BROMIDE AND ALBUTEROL SULFATEsolution [Nephron Pharmaceuticals Corporation]

Updated Date: Jul 8, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Dobutamine stress test and beta-agonist - a potential concern for nuclear cardiology testing: a case report

Conclusions: Beta-agonists pre-treatment with dobutamine stress testing may induce coronary spasm in association with chest pain and ST elevation. Clinicians and nuclear cardiologist should be aware of this potential side effect of beta-agonists treatment with dobutamine stress testing, particularly since dobutamine stress testing in nuclear cardiology is done in patient with chronic obstructive lung disease. (Source: Cases Journal)

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  Albuterol Found Ineffective in Acute Lung Injury

SAN FRANCISCO — A placebo-controlled clinical trial of albuterol in acute lung injury was terminated after the first interim analysis showed that the beta-2 agonist was no better than placebo. (Source: Hospitalist News)

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  Montelukast induced acute hepatocellular liver injury

Harugeri A, Parthasarathi G, Sharma J, D'Souza G A, Ramesh MJournal of Postgraduate Medicine 2009 55(2):141-142A 46-year-old male with uncontrolled asthma on inhaled albuterol and formoterol with budesonide was commenced on montelukast. He developed abdominal pain and jaundice 48 days after initiating montelukast therapy. His liver tests showed an increase in serum total bilirubin, conjugated bilirubin, aspartate aminotranferase, alanine aminotranferase, and alkaline phosphatase. The patient was evaluated for possible non-drug related liver injury. Montelukast was discontinued suspecting montelukast induced hepatocellular liver injury. Liver tests began to improve and returned to normal 55 days after drug cessation. Causality of this adverse drug reaction by the Council for Internat...

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  Albuterol Often Used Incorrectly for Children's Asthma Flare-Ups

Reuters Health Information (Source: Medscape Allergy Headlines)

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  Genetic variants of GSNOR and ADRB2 influence response to albuterol in African-American children with severe asthma

African Americans are disproportionately affected by asthma. Social and economic factors play a role in this disparity, but there is evidence that genetic factors may also influence the development of asthma and response to therapy in African American children. Our hypothesis is that variations in asthma related genes contribute to the observed asthma disparities by influencing the response to asthma-specific therapy. In order to test this hypothesis, we characterized the clinical response to asthma-specific therapy in 107 African American children who presented to the emergency room in status asthmaticus, with a primary outcome indicator of length of time on continuous albuterol. Single locus analysis indicated that genotype variation in glutathione-dependent S-nitrosoglutathione reductas...

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  Home use of albuterol for asthma exacerbations

(Source: Annals of Allergy, Asthma and Immunology)

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  Effects of Formoterol on Contraction and Ca2+ Signaling of Mouse Airway Smooth Muscle Cells.

Authors: Delmotte P, Sanderson MJ Formoterol, a long-acting ss2-receptor agonist, is used to relieve bronchial constriction. However, formoterol is often a racemic formulation and contains both (R,R)- and (S,S)-enantiomers. Because the activity of each isomer is poorly defined, the mechanisms by which formoterol relaxes smooth muscle cells (SMC) of intrapulmonary airways are not well understood. Consequently, we compared the effects of (S,S)-, (R,R)- and racemic formoterol, as well as (R)-albuterol, on the contraction and Ca(2+) signaling of airway SMCs in mouse lung slices with phase-contrast and confocal microscopy. Small airways were contracted with MCh and the associated SMCs displayed sustained Ca(2+) oscillations and an increase in Ca(2+) sensitivity. These contracted airways dis...

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  Indiana U. Research At The American College Of Sports Medicine Conference

CAFFEINE SHOWN AS EFFECTIVE AT REDUCING EXERCISE-INDUCED ASTHMA SYMPTOMS AS AN ALBUTEROL INHALER An Indiana University study found that the ingestion of caffeine within an hour of exercise can reduce the symptoms of exercise induced asthma (EIA). (Source: Health News from Medical News Today)

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  Pharmacogenomics of Acute Asthma: The β2-Adrenergic Receptor Gene as a Model for Future Therapy

Asthma is a complex heterozygous multifactorial condition with variability in clinical features and response to treatment, likely related to interactions between genetics and environmental exposures. Pharmacogenomic research seeks to identify and elucidate relationships between genetic variation and therapeutic response. Multiple studies have examined genetic variation in the β2-adrenergic receptor gene and association with asthma phenotypes. Results suggest that single-nucleotide polymorphisms in this gene are associated with greater bronchodilation acutely after albuterol, worse pulmonary function over time with daily albuterol use, and tachyphylaxis to albuterol with chronic use. Although these results are intriguing, there are limitations of individual studies and discrepancies among ...

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  Outbreak of Burkholderia cepacia bacteremia in immunocompetent children caused by contaminated nebulized sulbutamol in Saudi Arabia

To the Editor: From early spring 2003 through May 2004, hospitals across Saudi Arabia and the Gulf Cooperation Council States experienced outbreaks of Burkholderia cepacia nosocomial infections secondary to the use of contaminated multidose albuterol nebulization solutions that were manufactured and distributed in the Gulf Region. After an exhaustive investigation, the National Guard's Department of Infection Prevention and Control identified the cause of the outbreak, and triggered a regional recall of the contaminated product in April 2004 after which there were no further cases. The National Guard Hospital outbreak investigation, case descriptions and definitions, supporting laboratory data, and infection control recommendations were the subject of a detailed paper that was authored by...

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  Body mass index and phenotype in subjects with mild-to-moderate persistent asthma

Conclusions: Increased BMI is not associated with clinically significant worsening of impairment in subjects with mild-to-moderate persistent asthma. There is a modest association between increased BMI and reduced therapeutic effect of ICS-containing regimens in this patient population. Prospective studies evaluating the effect of being overweight or obese on treatment response in asthma are warranted. (Source: Journal of Allergy and Clinical Immunology)

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  Augmentation of bronchodilator responsiveness by leukotriene modifiers in Puerto Rican and Mexican children.

CONCLUSIONS: Among children with persistent asthma, use of leukotriene modifiers is associated with augmented bronchodilator responsiveness to albuterol in Puerto Ricans, but not Mexican Americans. This ethnic-specific, drug-drug interaction highlights the need for the further understanding of asthma pharmacogenetics among children from different ethnic groups to improve asthma outcomes. PMID: 19558011 [PubMed - in process] (Source: Annals of Allergy, Asthma and Immunology)

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  Home use of albuterol for asthma exacerbations.

CONCLUSIONS: Caregivers reported that they would use albuterol to treat their child's worsening asthma symptoms, but many described inappropriate use. Detailed evaluation of proper albuterol use at home may provide insight into how health care professionals can better educate and support parents in their management of acute exacerbations and more effective use of AAPs. PMID: 19558010 [PubMed - in process] (Source: Annals of Allergy, Asthma and Immunology)

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  Combivent (Ipratropium Bromide and Albuterol Sulfate) - updated on RxList

Combivent (Ipratropium Bromide and Albuterol Sulfate) drug description - FDA approved labeling for prescription drugs and medications at RxList (Source: RxList - New and Updated Drug Monographs)

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  High-Dose Continuous Nebulized Levalbuterol for Pediatric Status Asthmaticus: A Randomized Trial

Conclusions: Substituting high-dose continuous LEV for RAC did not reduce the time on continuous therapy and had similar adverse effects in children who had failed initial treatment with RAC. (Source: The Journal of Pediatrics)

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  Cellular coupling of potassium channels with β2 adrenoceptors in mediating myometrial relaxation in buffaloes (Bubalus bubalis)

Choudhury, S., Garg, S. K., Singh, T. U., Mishra, S. K. Cellular coupling of potassium channels with [beta]2 adrenoceptors in mediating myometrial relaxation in buffaloes (Bubalus bubalis). J. vet. Pharmacol. Therap. doi: 10.1111/j.1365-2885.2009.01084.x. Present study unravels the functional presence of potassium channels and their involvement in mediating [beta]2 adrenoceptors-induced myometrial relaxation in buffalo myometrium. Isolated myometrial preparations exhibited rhythmic spontaneity with regular pattern of amplitude and frequency. Levcromakalim produced concentration-dependent inhibitory effect on myometrial spontaneity and relaxant effect and the dose[ndash]response curve (DRC) was shifted towards right in the presence of glybenclamaide. In the tissues pretreated with glybencla...

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  CLINICAL PRACTICE: Asthma in Pregnancy

A 23-year-old nonsmoking woman (gravida 1, para 0) presents at 11 weeks' gestation with an 8-year history of asthma, which has worsened over the past year. She reports symptoms requiring albuterol two or three times per day and interfering with sleep. Her forced expiratory volume in 1 second is 75% of the predicted value; it increases to 88% after administration of albuterol. How should her case be managed? (Source: New England Journal of Medicine)

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  MediciNova Reports Final Data from Phase II MN-221 Emergency Department Clinical Trial (MN-221-CL-006); Hospitalization Rates Decrease 45 Percent With MN-221 Plus Standardized Care in Asthma Patients

SAN DIEGO, April 22, 2009 (GLOBE NEWSWIRE) -- MediciNova, Inc., a biopharmaceutical company that is publicly traded on the Nasdaq Global Market (Nasdaq:MNOV) and the Hercules Market of the Osaka Securities Exchange (Code Number: 4875), today announced final results from its Phase II clinical trial (MN-221-CL-006) evaluating MN-221 at planned escalating doses of 240 to 1,080 micrograms in patients with severe, acute exacerbations of asthma treated in Emergency Departments. The study included 29 (13 treated with standard care only and 16 treated with MN-221 plus standard care) patients with severe, acute exacerbations of asthma. All patients received standardized care consisting of inhaled albuterol, ipratropium and oral steroid treatment. No safety concerns with adding MN-221 to standardize...

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  Enantiomer-Specific Effects of Albuterol on Airway Inflammation in Healthy and Asthmatic Cats

Int Arch Allergy Immunol 2009;150:43-50 (DOI:10.1159/000210379) (Source: International Archives of Allergy and Immunology)

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  The effect of sex on asthma control from the National Asthma Survey

Conclusions: Women demonstrated worse asthma control compared with men with regard to several short-term and long-term measures, despite reporting higher rates of inhaled corticosteroid use and routine asthma care visits. Further studies are needed to elucidate whether these findings are due to differences in health reporting or to pathophysiologic differences in asthma between the sexes. (Source: Journal of Allergy and Clinical Immunology)

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  [Asthma] In vivo uptake of inhaled particles by airway phagocytes is enhanced in patients with mild asthma compared with normal volunteers

Conclusions: In vivo particle uptake by airway macrophages is enhanced in persons with mild asthma. Enhanced uptake and processing of particulate antigens could contribute to the pathogenesis and progression of allergic airways disease and may contribute to the increased risk of disease exacerbation associated with particulate exposure. (Source: Thorax)

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  Modulation of epidermal growth factor receptor binding to human airway smooth muscle cells by glucocorticoids and {beta}2-adrenergic receptor agonists

EGF receptors (EGFRs) are increased in airway smooth muscle in asthma, which may contribute to both their hyperproliferation and hypercontractility. Lysophosphatidic acid (LPA) is a candidate pathological agent in asthma and other airway diseases, and LPA upregulates EGFRs in human airway smooth muscle (HASM) cells. We tested whether therapeutic glucocorticoids and/or β2-adrenergic receptor (β2AR) agonists also alter EGFR binding in HASM cells. Exposure to glucocorticoids for 24 h induced a twofold increase in EGFR binding similar to that with LPA; fluticasone was markedly more potent than dexamethasone. The increase in EGFR binding by glucocorticoids required 24-h exposure, consistent with transcription-mediated effects. Although the increase in EGFR binding was blocked by the p...

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  A Healthy 22-year-old Woman With New Onset Dyspnea

An otherwise healthy 22-year-old woman sought treatment for acute dyspnea at the Johns Hopkins Hospital emergency department near the end of November 2006. The woman denied any history of asthma, allergies, smoking, or other pulmonary or cardiac disease. She had experienced a healthy childhood and was up to date with all standard immunizations. The young woman first noted dyspnea on exertion in late spring of the same year. By June, she reported, “I felt like I was going to die when I was swimming.” By July, the patient was experiencing dyspnea with mild exertion, and by August the symptoms occurred at rest. At that time, the patient went to her family physician, who diagnosed asthma and prescribed albuterol (Proventil, Ventolin). However, the inhaler provided no relief. That same mont...

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  Final Count Down to HFA Albuterol Inhalers: Are We Ready as Yet?

(Source: Clinical Pediatrics)

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  FDA Safety Changes: Combivent, Qualaquin, Sucraid

The FDA has approved revisions to the safety labeling for ipratropium bromide and albuterol sulfate inhalation aerosol, quinine sulfate capsules, and sacrosidase oral solution. Medscape Medical News (Source: Medscape Medical News Headlines)

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  FDA Safety Changes: Combivent, Qualaquin, Sucraid

The FDA has approved revisions to the safety labeling for ipratropium bromide and albuterol sulfate inhalation aerosol, quinine sulfate capsules, and sacrosidase oral solution. Medscape Medical News (Source: Medscape Medical News Headlines)

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  Efficacy of Inhaled Corticosteroids in Infants and Preschoolers With Recurrent Wheezing and Asthma: A Systematic Review With Meta-analysis

CONCLUSIONS. Infants and preschoolers with recurrent wheezing or asthma had less wheezing/asthma exacerbations and improve their symptoms and lung function during treatment with inhaled corticosteroids. (Source: PEDIATRICS)

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  Socioeconomic, Family, and Pediatric Practice Factors That Affect Level of Asthma Control

CONCLUSIONS. Despite substantial use of daily controller medication, children with asthma continue to experience poorly controlled asthma and reduced quality of life. Although Medicaid insurance and aspects of family structure are significant factors associated with poorly controlled asthma, attention to medication use and quality-of-life indicators may further reduce morbidity. (Source: PEDIATRICS)

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  Effect of interleukin 13 on bronchial hyperresponsiveness and the bronchoprotective effect of beta-adrenergic bronchodilators and corticosteroids.

CONCLUSIONS: The protective effects of fluticasone, beta-agonists, and fluticasone plus beta-agonists are significantly less in IL-13-treated mice than in nonsensitized or ovalbumin-sensitized mice. PMID: 19354064 [PubMed - indexed for MEDLINE] (Source: Annals of Allergy, Asthma and Immunology)

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  Modulation of Epidermal Growth Factor Receptor Binding to Human Airway Smooth Muscle Cells by Glucocorticoids and Beta-2 Adrenergic Receptor Agonists.

Authors: Kassel KM, Schulte NA, Toews ML Epidermal growth factor receptors (EGFRs) are increased in airway smooth muscle in asthma, which may contribute to both their hyperproliferation and hypercontractility. Lysophosphatidic acid (LPA) is a candidate pathologic agent in asthma and other airway diseases, and LPA up-regulates EGFRs in human airway smooth muscle (HASM) cells. We tested whether therapeutic glucocorticoids and/or beta-2 adrenergic receptor (beta2AR) agonists also alter EGFR binding in HASM cells. Exposure to glucocorticoids for 24 hr induced a two-fold increase in EGFR binding similar to that with LPA; fluticasone was markedly more potent than dexamethasone. The increase in EGFR binding by glucocorticoids required 24-hr exposure, consistent with transcription-mediated eff...

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  ALBUTEROL SULFATEsolution [Qualitest Pharmaceuticals]

Updated Date: Feb 5, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Clinical Scenario—An 18-Year-Old With Acute Dysphagia and Meat Impaction

A healthy 18-year-old male subject presented to the emergency department with acute dysphagia and odynophagia immediately after eating steak. He regurgitated several times, with no relief of his symptoms. His medical history was remarkable for asthma and seasonal and environmental allergies, for which he was treated with, as needed, albuterol inhaler and montelukast. He also had a remote episode of apparent anaphylaxis to shellfish requiring an emergency department visit. On examination he was seen in the emergency department in some distress, holding a cup into which he was periodically expectorating saliva. Emergent examination of the esophagus with a flexible endoscope revealed total blockage of the lower esophagus caused by impaction of a meat bolus. The endoscopic appearance of the es...

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  The effect of sex on asthma control from the National Asthma Survey.

CONCLUSIONS: Women demonstrated worse asthma control compared with men with regard to several short-term and long-term measures, despite reporting higher rates of inhaled corticosteroid use and routine asthma care visits. Further studies are needed to elucidate whether these findings are due to differences in health reporting or to pathophysiologic differences in asthma between the sexes. PMID: 19181370 [PubMed - as supplied by publisher] (Source: Journal of Allergy and Clinical Immunology)

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  ORIGINAL ARTICLE: Oral Prednisolone for Preschool Children with Acute Virus-Induced Wheezing

In this study, no benefit in the duration of in-hospital treatment was noted among children who received oral prednisolone, as compared with placebo; all children were treated with inhaled albuterol. (Source: New England Journal of Medicine)

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  Drug Shortages: Resolved Drug Shortages; Albuterol Metered Dose Inhalers and Levalbuterol Metered Dose Inhalers

The transition from albuterol CFC MDIs to albuterol HFA MDIs is now complete and supplies of albuterol HFA and levalbuterol HFA MDIs continue to meet total market demand. (Source: FDA Drug Shortages)

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  Drug Shortages: Resolved Drug Shortages; Albuterol Metered Dose Inhalers and Levalbuterol Metered Dose Inhalers

The transition from albuterol CFC MDIs to albuterol HFA MDIs is now complete and supplies of albuterol HFA and levalbuterol HFA MDIs continue to meet total market demand. (Source: FDA Drug Shortages)

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  MediciNova Reports Interim Phase II Data From MN-221 Emergency Department Study

SAN DIEGO, Jan. 12, 2009 (GLOBE NEWSWIRE) -- MediciNova, Inc., a biopharmaceutical company that is publicly traded on the Nasdaq Global Market (Nasdaq:MNOV) and the Hercules Market of the Osaka Securities Exchange (Code Number: 4875), today announced interim results from two planned reviews of the unaudited data for its MN-221-CL-006 Phase II study, which remains ongoing. These reviews included data from a total of 18 (eight treated with standard care only and ten treated with MN-221 plus standard care) of 36 planned patients with severe, acute exacerbations of asthma treated in emergency departments. All patients received standardized care consisting of inhaled albuterol, ipratropium and oral steroid treatment. No safety concerns with adding MN-221 to standardized care were identified in ...

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  Selection of My Twitter Favorites, Edition 30

Twitter is a microblogging service where people answer the question "What are you doing?" via 140-character messages from their cellphone, laptop or desktop. You can select the messages you find useful, amusing, or both. Here is the 30th edition of My Twitter Favorites (the oldest post is at the bottom, the newest at the top):shellen For 2009, I'm thinking of trying this ridiculous new diet where you eat right and excercise. Crazy, right? 10:43 PM Jan 1st from Tweetie pyknosis Struck up a conversation with the lady at Tapioca Express. Turns out she was an MD in China. Now she's making me a honeydew snowbubble. Sad. 10:07 PM Jan 1st from Tweetie timoreilly "US Air Force Rules of Engagement for Blogging" flowchart diagram http://tinyurl.com/axgh9c (via @davemc500hats) is more for blog re...

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  ALBUTEROL SULFATEsolution [Bausch Lomb Incorporated]

Updated Date: Jan 5, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  PROVENTIL HFA (Albuterol Sulfate) Aerosol, Metered [Schering Corporation]

Updated Date: Jan 5, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Albuterol metered dose inhaler performance under hyperbaric pressures.

Authors: Johnson GA, Gutti VR, Loyalka SK, O'Beirne KA, Cochran SK, Dale HM, Kracke GR The weight change per actuation and aerosol particle size and number delivered by albuterol metered dose inhalers (MDIs) were measured in a multiplace hyperbaric chamber at pressures ranging from one atmosphere absolute (1 ATA, 0 feet of seawater, fsw, 101 kPa) to three ATA (66 fsw, 304 kPa). Weight change per actuation by CFC (chlorofluorocarbon) and long canister HFA (hydrofluoroalkane) powered MDIs was 13 +/- 1% and 12 +/- 1% less, respectively, at 3 ATA compared to 1 ATA. However, weight change per actuation by short canister HFA MDIs was not significantly changed with pressure. The geometric mean diameters of nano particles from the CFC and short canister HFA MDIs decreased from 50 nm at 0 fsw t...

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  Wal-Mart offers albuterol inhaler for $9

BENTONVILLE, Ark., Dec. 31 (UPI) -- Wal-Mart has announced it will carry an environmentally friendly albuterol rescue inhaler starting at $9, company officials in Bentonville, Ark., said. (Source: Health News - UPI.com)

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  COMBIVENT (Ipratropium Bromide And Albuterol Sulfate) Aerosol, Metered [Boehringer Ingelheim Pharmaceuticals, Inc.]

Updated Date: Dec 19, 2008 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Air-Based Asthma Medication Inhaler That Does Not Use A Refrigerant Propellant

Inhalers used for delivering albuterol, a fast-acting bronchial dialator, currently use propellants such as ozone-depleting CFC's, which are banned by the FDA beginning December 31st, 2009, or replacement HFA's. Both propellants are also used as industrial refrigerants and eject the medicine, albuterol, at near-supersonic speeds. (Source: Asthma / Respiratory News From Medical News Today)

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  New Rules for Inhalers Start With New Year

Chlorofluorocarbon inhalers are down to their last gasps -- literally. Changes mandated by the federal government in 2005 take effect Jan. 1, meaning physicians are running out of time to transition patients from albuterol metered-dose inhalers that use chlorofluorocarbons, or CFCs, as propellants to inhalers that use the more ozone-friendly propellant hydrofluoroalkane, or HFA. (Source: AAFP Health of the Public)

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  Beneficial Effects of Warmed Humidified Oxygen Combined with Nebulized Albuterol and Ipratropium in Pediatric Patients with Acute Exacerbation of Asthma in Winter Months

Conclusion: Our study shows that warmed humidified oxygen given along with the combination of nebulized albuterol and ipratropium is more beneficial for pediatric patients having an acute exacerbation of bronchial asthma in the winter months when compared to nebulized albuterol alone with warmed humidified oxygen, nebulized albuterol alone with room temperature humidified oxygen, or a combination of nebulized albuterol and ipratropium with room temperature humidified oxygen. (Source: The Journal of Emergency Medicine)

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  albuterol, Ventolin, Proventil, AccuNeb, Vospire, ProAir

Title: albuterol, Ventolin, Proventil, AccuNeb, Vospire, ProAirCategory: MedicationsCreated: 12/31/1997Last Editorial Review: 11/26/2008 (Source: MedicineNet Asthma General)

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  ALBUTEROL SULFATEsyrup [Actavis Mid Atlantic LLC]

Updated Date: Nov 26, 2008 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  {beta}2-Adrenergic Receptor Polymorphisms Affect Response to Treatment in Children With Severe Asthma Exacerbations.

Conclusions In this cohort of children with severe asthma exacerbations, children homozygous for glycine at amino acid position 16 of the beta(2)-AR had a more rapid response to beta(2)-AR agonist treatment. PMID: 19029431 [PubMed - as supplied by publisher] (Source: Chest)

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  Physicians Urged to Educate Patients on HFA Albuterol Inhalers

The American College of Allergy, Asthma and Immunology (ACAAI) is ramping up efforts to get physicians and the medical community to educate their respiratory disease patients about the upcoming discontinuation of albuterol inhalers using chlorofluorocarbon (CFC) propellants. Reuters Health Information (Source: Medscape Today Headlines)

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  ACAAI: Newer Albuterol Inhalers Not Created Equal

SEATTLE (MedPage Today) -- Asthma patients may need to be more diligent about washing one type of the newer, environmentally friendly albuterol inhalers than they are with others, said a researcher here. (Source: MedPage Today Allergy)

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  Quality of Care for Children Hospitalized With Asthma

CONCLUSIONS. Nine appropriate, feasible, reliable, clinical process measures of inpatient asthma care were identified. Provider compliance across these measures was highly variable but generally low. Our study highlights opportunities for improvement in the provision of asthma care for hospitalized children. Future studies are needed to confirm these findings in other inpatient settings. (Source: PEDIATRICS)

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  Value of the Bronchodilator Response in Assessing Controller Naive Asthmatic Children

CONCLUSIONS. Spirometric criteria that include BDR can potentially identify children who have clinically mild asthma and might benefit from controller therapy. REVIEWER COMMENTS. What a breath of fresh air (pardon the pun). Establishing a firm diagnosis of asthma in pediatric patients can be, at times, a real challenge. Clinical history, physical examination, and a low FEV1 are all very useful in the diagnosis, but there are convincing data in children showing that an isolated, baseline FEV1 is not a good measure of the presence of asthma or its severity. The findings from this investigation demonstrate that detecting bronchodilator responsiveness (ie, 9% cutoff value for improvement in FEV1 after inhaled albuterol by metered-dose inhaler or nebulizer) can certainly aid in the diagnosis of...

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  Nebulized Perforomist Inhalation Solution Provided Prolonged Bronchodilation and Increased Patient Satisfaction Compared to Albuterol/Ipratropium MDI

    PHILADELPHIA, October 29, 2008 /PRNewswire-USNewswire/ -- Data from a Phase IIIb clinical trial demonstrate that Perforomist(TM) (formoterol fumarate) Inhalation Solution nebulized treatment provided prolonged bronchodilation and... (Source: Drugs.com - Clinical Trials)

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  Risk of Adverse Gastrointestinal Events from Inhaled Corticosteroids

Conclusion. Patients using inhaled corticosteroids appear to have a slight risk for adverse gastrointestinal events that is mitigated in patients who used a spacer device. (Source: Pharmacotherapy: Official Journal of the American College of Clinical Pharmacy)

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  Episodic use of an inhaled corticosteroid or leukotriene receptor antagonist in preschool children with moderate-to-severe intermittent wheezing.

CONCLUSIONS: In preschool children with moderate-to-severe intermittent wheezing, episodic use of either budesonide or montelukast early in RTIs, when added to albuterol, did not increase the proportion of EFDs or decrease oral corticosteroid use over a 12-month period. However, indicators of severity of acute illnesses were reduced, particularly in children with positive asthma predictive indices. PMID: 18973936 [PubMed - as supplied by publisher] (Source: Journal of Allergy and Clinical Immunology)

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  FDA Approvals: ProAir HFA and Nasacort AQ

The FDA has approved expanded indications for an albuterol sulfate inhalation aerosol (ProAir HFA) and triamcinolone acetonide nasal spray (Nasacort AQ). Medscape Medical News (Source: Medscape Medical News Headlines)

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  Safety and tolerability of inhaled hypertonic saline in young children with cystic fibrosis

Inhaled hypertonic saline (HS) improves lung function and decreases pulmonary exacerbations in older patients with cystic fibrosis (CF). Initiating therapies in young patients has potential to preserve lung function. Before conducting a therapeutic trial of HS in this population, its safety must be evaluated and protocols for monitoring response must be tested.We administered single dose 3% and 7% HS post-albuterol to 4-7 year-olds with CF able to perform spirometry ("preschool" group) and 4 month to 3 year-olds ("infant" group) using the raised volume rapid thoracoabdominal compression technique (RVRTC). Vital signs and cough episodes were measured after each inhaled treatment.Eight preschool subjects (mean age 5.7 ± 0.8 years) and 6 infants (1.6 ± 1.0 years) completed the 3% HS protoco...

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  Modifiable Risk Factors for Suboptimal Control and Controller Medication Underuse Among Children With Asthma

CONCLUSIONS. Deficiencies in asthma control and controller medication use are associated with potentially modifiable parental beliefs, which seem to mediate racial/ethnic and socioeconomic disparities in suboptimal control and controller medication underuse. (Source: PEDIATRICS)

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  FDA Drug Safety Podcast

Transition from Chlorofluorocarbon (CFC) Propelled Albuterol Inhalers to Hydrofluroalkane (HFA) Propelled Albuterol Inhalers (Source: FDA Center for Drug Evaluation and Research - What's New)

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  Teva's ProAir HFA, the Market Leading Albuterol Inhaler, Receives New Pediatric Indication

JERUSALEM--(BUSINESS WIRE)--Sept. 23, 2008 - Teva Pharmaceutical Industries Ltd. today announced that the U.S. Food and Drug Administration (FDA) has approved ProAir HFA (albuterol sulfate) Inhalation Aerosol for use in patients as young as 4 years... (Source: Drugs.com - New Drug Approvals)

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  Steroids completely reverse albuterol-induced beta(2)-adrenergic receptor tolerance in human small airways.

CONCLUSION: These data suggest that beta(2)-AR desensitization occurs with prolonged treatment of human small airways with albuterol through mechanisms upstream of protein kinase A and that steroids prevent or reverse this desensitization. Clarifying the precise molecular mechanisms by which beta(2)-AR tolerance occurs might offer new therapeutic approaches to improve the efficacy of bronchodilators in asthma and chronic obstructive pulmonary disease. PMID: 18774166 [PubMed - as supplied by publisher] (Source: Journal of Allergy and Clinical Immunology)

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  Albuterol vs Montelukast for Exercise-Induced Bronchospasm in Children: A Best Evidence Review

This Best Evidence Review weighs in on a study from Pharmacotherapy determining the better choice for preventing exercise-induced asthma. Medscape Family Medicine (Source: Medscape Allergy Headlines)

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  [Original articles] Homocysteine, migration and early vascular impairment in people of African descent

Conclusions: Lower folate concentrations in UK compared with West Indian African-Caribbeans may contribute to the higher stroke risk seen in UK African-Caribbean people. (Source: Heart)

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  Unlikely Victims of Banning CFCs--Asthma Sufferers [Scientific American Magazine]

A federal ban on ozone-depleting chlorofluorocarbons (CFCs), to conform with the Clean Air Act, is, ironically, affecting 22.9 million people in the U.S. who suffer from asthma. Generic inhaled albuterol, which is the most commonly prescribed short-acting asthma medication and requires CFCs to propel it into the lungs, will no longer be legally sold after December 31, 2008. Physicians and patients are questioning the wisdom of the ban, which will have an insignificant effect on ozone but a measurable impact on wallets: the reformulated brand-name alternatives can be three times as expensive, raising the cost to about $40 per inhaler. The issue is even more disconcerting considering that asthma disproportionately affects the poor and that, according to recent surveys, an estimated 20 percen...

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  Variation in pediatric hospitalists' use of proven and unproven therapies: A study from the Pediatric Research in Inpatient Settings (PRIS) network

Undesirable practice variation remains a major concern with the quality of the healthcare system. While care in pediatric hospitalist systems has been demonstrated to be efficient, neither the quality of care nor determinants of variation in pediatric hospitalist systems are well understood.To measure variation in pediatric hospitalists' reported use of common inpatient therapies, and to test the hypothesis that variation in reported use of proven therapies is lower than variation in reported use of unproven therapies.We conducted a survey of pediatric hospitalists in the US and Canada. Respondents reported their frequency of using 14 therapies in the management of common conditions. Each therapy was determined to be of proven or unproven effectiveness using published critical appraisals. ...

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  A cumulative dose study of levalbuterol and racemic albuterol administered by hydrofluoroalkane-134a metered-dose inhaler in asthmatic subjects.

CONCLUSION: In this study single-day cumulative dosing of asthmatic subjects with levalbuterol HFA MDI or racemic albuterol HFA MDI resulted in similar improvements in FEV(1) and tolerability. Plasma (R)-albuterol levels and mean heart rate were less with levalbuterol HFA MDI. PMID: 18692886 [PubMed - as supplied by publisher] (Source: Journal of Allergy and Clinical Immunology)

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  Neuralgic Amyotrophy Associated with Antibiotic Therapy (September).

CONCLUSIONS: Clinicians should be aware of this adverse reaction when facing similar complex neurologic symptoms in patients who are receiving the antibiotic treatment described here, especially vancomycin. PMID: 18682542 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)

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  Increased use of beta-agonists leading to non-ST-segment elevation myocardial infarction in a patient with hemodynamically significant myocardial bridging.

We describe an unusual case of a 47-year-old woman whose increased use of inhaled albuterol led to a non-ST-segment elevation myocardial infarction and unmasking of hemodynamically significant myocardial bridging. We detail its diagnosis through myocardial perfusion imaging and coronary angiography. To our knowledge, this is the first time previously undiagnosed myocardial bridging has led to a myocardial infarction in the setting of inhaled albuterol use. PMID: 18674481 [PubMed - in process] (Source: Mayo Clinic Proceedings)

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  Switch to HFA-Propelled Albuterol Inhalers Now, FDA Advisory Urges

More information about the transition is available at www.inhalertransition.org, www.transitionnow.org, and www.pparx.org. In a public health advisory, the Food and Drug Administration is urging health care professionals and their patients and caregivers to switch to hydrofluoroalkane-propelled albuterol inhalers before chlorofluorocarbon-propelled inhalers are taken off the market Jan. 1, 2009. (Source: Pediatric News)

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  Inhaled Steroids Improve Bronchodilator Response in Latino Asthmatics

Among patients with persistent asthma, use of inhaled corticosteroids is associated with enhanced bronchodilator responsiveness to albuterol in Latinos but not African Americans, researchers report in the June issue of the Annals of Allergy, Asthma, and Immunology. Reuters Health Information (Source: Medscape Medical News Headlines)

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  Accuneb(Albuterol Sulfate) Solution [DEY]

Updated Date: Jul 25, 2008 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Inhaled corticosteroid (ICS) use appears to increase response to salbutamol [albuterol] in Latin American, but not African American, patients

(Source: Inpharma)

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