No. Records Request 1 1579 ASTHMA 2 18320 CHILD 3 432 #1 and #2 4 182 ALBUTEROL * 5 26 #3 and #4 Record 1 of 26 - MEDLINE (R) 1994 TI: A clinical study of colchicine in childhood asthma. AU: Adalioglu-G; Turktas-I; Saraclar-Y; Tuncer-A SO: J-Asthma. 1994; 31(5): 361-6 LA: ENGLISH AB: A double-blind, randomized, crossover study was done to determine the efficacy of colchicine in 30 atopic children with moderately severe asthma. A constant dose of sustained-release theophylline and salbutamol by inhalation, as needed, was administered to all patients. Compared to placebo, colchicine, 0.5 mg twice daily, significantly reduced morning tightness and nocturnal asthma score. There was, however, no significant difference between colchicine and placebo for cough, daytime asthma, or daily combined symptom scores for each patient. Colchicine did not significantly decrease beta-2 agonist inhaler use when compared with placebo. Similarly, there was no statistically significant difference between placebo and colchicine therapy as far as pulmonary function tests and peak flow reversibility were concerned. Thus, colchicine administered for 4 weeks demonstrated insufficient antiasthma activity. Colchicine-induced clinical improvement that was reported in a previous study may be due to selection of patients with mild asthma symptoms. However, our group, comprised of moderately severe asthmatic patients, did not show a satisfactory clinical response. MESH: Albuterol-administration-and-dosage; Albuterol-therapeutic-use; Asthma-physiopathology; Child-; Cross-Over-Studies; Double-Blind-Method; Placebos-; Respiratory-Function-Tests MESH: *Asthma-drug-therapy; *Colchicine-therapeutic-use AN: 95014003 -------------------------------------------------------------------------------- Record 2 of 26 - MEDLINE (R) 1994 TI: Compliance with pharmacologic prophylaxis and therapy in bronchial asthma. AU: Alessandro-F; Vincenzo-ZG; Marco-S; Marcello-G; Enrica-R SO: Ann-Allergy. 1994 Aug; 73(2): 135-40 LA: ENGLISH AB: Between January 1 and December 31, 1988, 288 children [185 boys and 103 girls, mean age 8.75 +/- 4.98 years (range 2.50 to 16.83)], followed at the Outpatient Clinic for Lung Diseases of the University of Milan 5th Pediatric Department, were interviewed blindly in order to assess their compliance with pharmacologic therapy. All children were suffering from episodic, frequent, or chronic asthma requiring therapy as needed and preventive drugs for at least 30 days. Prophylaxis (including cromolyn, beclomethasone, theophylline retard, ketotifen, oxatomide, albuterol, and prednisone, alone or in combinations) and therapy in case of symptoms (albuterol, with or without theophylline prompt or beclomethasone) were prescribed. A study questionnaire was completed 30 to 45 days after the prescription with no advance warning by a physician unaware of the prophylactic and therapeutic prescriptions. Out of the 288 patients, 31 (10.8%) failed to return for the second visit. Understanding of prophylaxis was full in 61.1% of cases, partial in 23.3% and nil in 4.9%. Therapy as needed was fully remembered by 77.1% of parents, partially by 9.4% and totally forgotten by 2.8%. Compliance with single-drug prophylaxis was full in 60.1% of cases, partial in 22.2% and nil in 6.4%. Statistical analysis showed compliance was significantly better for ketotifen than for disodium cromoglycate (chi squared 9.85, P < .02), for ketotifen than for theophylline (chi squared 9.98, P < .02), and for beclomethasone than for theophylline (chi squared 8.77, P < .05).(ABSTRACT TRUNCATED AT 250 WORDS) MESH: Administration,-Inhalation; Adolescence-; Albuterol-therapeutic-use; Beclomethasone-therapeutic-use; Bronchodilator-Agents-administration-and-dosage; Child-; Child,-Preschool; Cromolyn-Sodium-therapeutic-use; Histamine-H1-Antagonists-administration-and-dosage; Questionnaires-; Theophylline-therapeutic-use MESH: *Asthma-drug-therapy; *Asthma-prevention-and-control; *Bronchodilator-Agents-therapeutic-use; *Histamine-H1-Antagonists-therapeutic-use; *Patient-Compliance AN: 94346650 -------------------------------------------------------------------------------- Record 3 of 26 - MEDLINE (R) 1994 TI: A 1-week dose-ranging study of inhaled salmeterol in patients with asthma. AU: Bronsky-EA; Kemp-JP; Orgel-HA; Bierman-CW; Tinkelman-DG; van-As-A; Liddle-RF SO: Chest. 1994 Apr; 105(4): 1032-7 LA: ENGLISH AB: STUDY OBJECTIVE: A dose-ranging study was conducted to evaluate the efficacy and safety of a new long-acting, selective beta 2-adrenoceptor agonist, salmeterol. DESIGN: Adolescents and adults (N = 160) with mild-to-moderate asthma received salmeterol (10.5, 21, 42, or 84 micrograms) or placebo by metered-dose inhaler twice daily for 1 week. Twelve-hour serial spirometry measurements were performed on the first and last days of treatment, and patients recorded their peak expiratory flow (PEF) twice daily on diary cards. RESULTS: On day 1, salmeterol produced greater bronchodilation than placebo (p = 0.001), and both the 42-micrograms and 84-micrograms doses of salmeterol were significantly more effective in improving FEV1 responses than the two lower doses of salmeterol (p < 0.05). After 1 week of treatment, all but the 21-micrograms dose of salmeterol remained statistically superior to placebo (p < 0.01), but significant differences between salmeterol doses were no longer evident, despite an apparent dose-response effect. Only the 42-micrograms and 84-micrograms doses of salmeterol sustained bronchodilation for 12 h in the majority of patients at both treatment days. The degree of improvement in morning and evening PEF was also found to be dose related. There was no significant difference among treatment groups in the overall incidence of adverse events; however, pharmacologically predictable events (eg, tremor) occurred significantly more often with salmeterol, 84 micrograms. CONCLUSIONS: Salmeterol, 42 micrograms, was similar in efficacy to 84 micrograms but was associated with a lower incidence of adverse events. Salmeterol, 42 micrograms twice daily, is a safe and effective dosage for patients with mild-to-moderate asthma who are persistently symptomatic and require maintenance bronchodilator therapy. MESH: Administration,-Inhalation; Adolescence-; Adrenergic-beta-Agonists-adverse-effects; Adult-; Albuterol-administration-and-dosage; Albuterol-adverse-effects; Asthma-physiopathology; Bronchodilator-Agents-administration-and-dosage; Bronchodilator-Agents-adverse-effects; Child-; Dose-Response-Relationship,-Drug; Double-Blind-Method; Forced-Expiratory-Volume; Maximal-Midexpiratory-Flow-Rate; Middle-Age; Nebulizers-and-Vaporizers; Peak-Expiratory-Flow-Rate MESH: *Adrenergic-beta-Agonists-administration-and-dosage; *Albuterol-analogs-and-derivatives; *Asthma-drug-therapy AN: 94215337 -------------------------------------------------------------------------------- Record 4 of 26 - MEDLINE (R) 1994 TI: Remission of childhood asthma after long-term treatment with an inhaled corticosteroid (budesonide): can it be achieved? Dutch CNSLD Study Group. AU: van-Essen-Zandvliet-EE; Hughes-MD; Waalkens-HJ; Duiverman-EJ; Kerrebijn-KF SO: Eur-Respir-J. 1994 Jan; 7(1): 63-8 LA: ENGLISH AB: This study was undertaken in order to determine whether long-term treatment with inhaled corticosteroid can induce a remission in childhood asthma, and to decide when stabilization of airway responsiveness occurred. We therefore carried out, an extended follow-up of 28-36 months in one of two groups of children who participated in a long-term intervention study. This former study had shown that long-term (median follow-up 22 months) treatment with inhaled corticosteroid plus beta 2-agonist improves symptoms, airway calibre and airway responsiveness in children with asthma, compared with beta 2-agonist alone. On treatment with inhaled corticosteroid plus beta 2-agonist, airway calibre did not further improve after 4 months, whereas the provocative dose of histamine which causes a 20% fall in forced expiratory volume in one second (PD20) histamine showed gradual improvement without reaching an apparent plateau. Remission was defined as being symptom free during any 8 month period. Of the 58 children originally randomized to receive 0.2 mg salbutamol, plus 0.2 mg budesonide, t.i.d., five children withdrew: three due to lack of motivation, one for psychological reasons, and one due to a deterioration of asthma. One patient was hospitalized because of an asthma exacerbation. Airway calibre showed no improvement after 4 months up to 36 months. Mean PD20 histamine stabilized after 20 months at 2.1 doubling doses above baseline, but at a subnormal level of 80 micrograms. Symptoms improved during the first 18 months, and may have been improving further, but slowly, during the period between 18 and 36 months.(ABSTRACT TRUNCATED AT 250 WORDS) MESH: Administration,-Inhalation; Adolescence-; Adrenergic-beta-Agonists-administration-and-dosage; Aerosols-; Albuterol-therapeutic-use; Bronchial-Provocation-Tests; Bronchodilator-Agents-administration-and-dosage; Child-; Drug-Therapy,-Combination; Follow-Up-Studies; Glucocorticoids,-Synthetic-administration-and-dosage; Pregnenediones-administration-and-dosage; Time-Factors MESH: *Asthma-drug-therapy; *Bronchodilator-Agents-therapeutic-use; *Glucocorticoids,-Synthetic-therapeutic-use; *Pregnenediones-therapeutic-use AN: 94192784 -------------------------------------------------------------------------------- Record 5 of 26 - MEDLINE (R) 1994 TI: Inhaled formoterol in the prevention of exercise-induced bronchoconstriction in asthmatic children. AU: Boner-AL; Spezia-E; Piovesan-P; Chiocca-E; Maiocchi-G SO: Am-J-Respir-Crit-Care-Med. 1994 Apr; 149(4 Pt 1): 935-9 LA: ENGLISH AB: The duration and magnitude of the effect of inhaled formoterol (12 micrograms) against exercise-induced bronchoconstriction (EIB) was compared with that of inhaled salbutamol (200 micrograms) and that of placebo in 15 children with asthma and EIB in a double-blind, double-dummy, within-patient, placebo-controlled study. The treatments were given by metered dose aerosol on three different days. The exercise test was performed at the 3rd and the 12th hour after dosing. The magnitude of the blocking effect was assessed both by evaluating the lowest FEV1 reading obtained within an hour after each exercise test and by considering the percent decrease below the baseline FEV1 measured before drug administration. Comparison of the lowest values obtained during the hour after each exercise test shows that formoterol was significantly better than both salbutamol (p = 0.022), and placebo (p = 0.001) in limiting exercise-induced bronchoconstriction after the first exercise test (3 h after dosing), while no difference was observed between salbutamol and placebo (p = 0.198). After the second exercise test (12 h after dosing), formoterol again proved to be more effective than both salbutamol (p = 0.008) and placebo (p = 0.001), and no significant difference was observed between salbutamol and placebo (p = 0.391). The evaluation of the mean percentage decrease in FEV1 confirmed the results in favor of formoterol in both the exercise tests. No adverse effects were reported in any treatment group. The protection against EIB is significantly more prolonged after formoterol than after salbutamol, and persists for 12 h after dosing. MESH: Administration,-Inhalation; Adrenergic-beta-Agonists-adverse-effects; Albuterol-administration-and-dosage; Asthma,-Exercise-Induced-physiopathology; Bronchodilator-Agents-adverse-effects; Child-; Double-Blind-Method; Ethanolamines-adverse-effects; Forced-Expiratory-Volume-drug-effects; Peak-Expiratory-Flow-Rate-drug-effects; Time-Factors MESH: *Adrenergic-beta-Agonists-administration-and-dosage; *Asthma,-Exercise-Induced-prevention-and-control; *Bronchoconstriction-drug-effects; *Bronchodilator-Agents-administration-and-dosage; *Ethanolamines-administration-and-dosage AN: 94191836 -------------------------------------------------------------------------------- Record 6 of 26 - MEDLINE (R) 1994 TI: [The effect of a single dose of formoterol using an aerosol inhaler in asthmatic children. A randomized, controlled, double-blind study] AU: Lebecque-P; Vliers-S; De-Saint-Moulin-T; Godding-V SO: Rev-Mal-Respir. 1994; 11(1): 47-50 LA: FRENCH; NON-ENGLISH AB: The duration of action of inhaled formoterol, a new long-acting beta-2-agonist, was compared to inhaled salbutamol and placebo in a double-blind, randomized, cross-over study in 16 children (8-12 years old) with stable moderate to serve asthma. Mean baseline FEV1 was 68 +/- 8% predicted. On the 4 study days, baseline FEV1 was within 15% of the FEV1 on visit 1. Two-three days apart, each patient inhaled either placebo, salbutamol (200 micrograms) formoterol (12 or 24 micrograms). FEV1 and PEF were measured repeatedly during 8 and 12 hours respectively. After formoterol, improvement over placebo remained significant at 8 hours for FEV1 (p = 0.006) and 12 hours for PEF (p = 0.01). When compared to salbutamol, it was significant at 8 hours for PEF (p = 0.03). There were no significant differences in lung function when comparing the 12 micrograms and 24 micrograms doses of formoterol. Side-effects were minimal. MESH: Adrenergic-beta-Agonists-administration-and-dosage; Adrenergic-beta-Agonists-adverse-effects; Aerosols-; Albuterol-administration-and-dosage; Albuterol-adverse-effects; Albuterol-therapeutic-use; Bronchodilator-Agents-administration-and-dosage; Bronchodilator-Agents-adverse-effects; Child-; Double-Blind-Method; Drug-Tolerance; English-Abstract; Ethanolamines-administration-and-dosage; Ethanolamines-adverse-effects; Forced-Expiratory-Volume-drug-effects; Nebulizers-and-Vaporizers; Peak-Expiratory-Flow-Rate-drug-effects; Placebos-; Time-Factors MESH: *Adrenergic-beta-Agonists-therapeutic-use; *Asthma-drug-therapy; *Bronchodilator-Agents-therapeutic-use; *Ethanolamines-therapeutic-use AN: 94174131 -------------------------------------------------------------------------------- Record 7 of 26 - MEDLINE (R) 1994 TI: Effective pulmonary blood flow in children with acute asthma attack requiring hospitalization. AU: Yiallouros-PK; Milner-AD SO: Pediatr-Pulmonol. 1994 Jun; 17(6): 370-7 LA: ENGLISH AB: In children with acute obstructive lung disease gas exchange is affected by ventilation-perfusion mismatch and the degree of bronchoconstriction. Standard lung function measurements do not reflect the impairment in gas exchange. Alternatively, the effective pulmonary blood flow (EPBF), that is, the proportion of the cardiac output that is supplying well-ventilated lung units, can give accurate and noninvasive estimates of ventilation-perfusion mismatch. We measured EPBF with the argon freon-22 rebreathing technique in children with acute severe asthma to assess their response to nebulized salbutamol and to determine whether induced changes in the EPBF could be predicted from baseline measurements. Twenty-four children admitted with an acute asthma attack had spirometry and triplicate EPBF measurements before and after nebulized salbutamol. Eighteen patients had repeated tests 50 days later when fully recovered; 4 patients were taking methylxanthines on at least one occasion. The mean forced expiratory volume in 1 sec (FEV1) rose from 55% of predicted to 66% after salbutamol and to 83% with recovery. The mean coefficients of variation for EPBF measurements on the three test occasions were 11.3%, 8.2%, and 9%. Except in children on methylxanthines, the EPBF values were reduced during the acute asthma attack (median, 2.53 L/min/m2; range, 1.99-3.60 L/min/m2) compared with paired values obtained after recovery (median, 2.89 L/min/m2; range, 2.28-4.04 L/min/m2) (P = 0.009). Salbutamol caused a highly significant increase in EPBF from 2.88 L/min/m2 (range, 1.86-3.80) before treatment to 3.34 L/min/m2 (range, 2.26-4.65) immediately afterwards (P = 0.0003).(ABSTRACT TRUNCATED AT 250 WORDS) MESH: Acute-Disease; Adolescence-; Aerosols-; Albuterol-therapeutic-use; Argon-; Asthma-drug-therapy; Bronchodilator-Agents-therapeutic-use; Case-Control-Studies; Child-; Child,-Preschool; Extravascular-Lung-Water; Forced-Expiratory-Volume; Freons-; Functional-Residual-Capacity; Heart-Rate; Hospitalization-; Lung-Volume-Measurements; Pulmonary-Gas-Exchange-drug-effects; Spirometry-; Stroke-Volume-physiology; Xanthines-therapeutic-use MESH: *Albuterol-pharmacology; *Asthma-physiopathology; *Lung-blood-supply; *Pulmonary-Gas-Exchange-physiology AN: 94377309 -------------------------------------------------------------------------------- Record 8 of 26 - MEDLINE (R) 1994 TI: Effects of salbutamol inhalations on transcutaneous blood gases in children during the acute asthmatic attack: from acute deterioration to recovery. AU: Holmgren-D; Sixt-R SO: Acta-Paediatr. 1994 May; 83(5): 515-9 LA: ENGLISH AB: Nine children, 7-16 years of age, were studied repeatedly during an acute asthmatic attack, from acute deterioration to recovery. The transcutaneous blood gases, forced expiratory volume in 1 s (FEV1) and maximum expiratory flow when 25% of vital capacity remained to be expelled (MEF25) were monitored before and after salbutamol inhalation. The flow-volume variables were markedly impaired in the acute phase but improved gradually by the time of recovery. The transcutaneous PO2 (tcPO2) decreased in the acute and early recovery phase but improved by the late recovery phase. In the acute phase, the salbutamol inhalations increased the FEV1, indicating an improvement in central airway function, but also reduced the MEF25 and tcPO2 in some of the children. The changes in tcPO2 after the inhalations correlated with the changes in MEF25 (p < 0.001), thereby indicating a common denominator, probably the condition of the peripheral airways. In the recovery phase, the FEV1, MEF25 and tcPO2 improved after the inhalations (p < 0.05). In conclusion, transcutaneous PO2 can be used to evaluate the effects of treatment in children with acute asthmatic symptoms and may add information about peripheral airway function which may prove particularly valuable in small children where few methods are available for such measurements. MESH: Acute-Disease; Adolescence-; Albuterol-therapeutic-use; Asthma-drug-therapy; Child-; Forced-Expiratory-Volume-drug-effects; Maximal-Expiratory-Flow-Rate-drug-effects MESH: *Albuterol-pharmacology; *Asthma-blood; *Blood-Gas-Monitoring,-Transcutaneous; *Carbon-Dioxide-blood; *Oxygen-blood AN: 94369171 -------------------------------------------------------------------------------- Record 9 of 26 - MEDLINE (R) 1994 TI: Anaesthetic management of an asthmatic child for appendicectomy. AU: Kuwahara-B; Goresky-GV SO: Can-J-Anaesth. 1994 Jun; 41(6): 523-6 LA: ENGLISH AB: A 13-yr-old boy was scheduled for emergency appendicectomy because of abdominal pain. His preoperative medical history was complicated by a recent hospital admission for management of asthma. He had presented to hospital seven days earlier because of dyspnoea, tachypnoea and oxygen desaturation to 77% on room air. Following admission, he required intensive nonventilatory management of his asthma, including intravenous salbutamol, methylprednisolone, and aminophylline, as well as use of an ipratroprium bromide inhaler and 100% oxygen by mask. He was discharged to the ward, and continued on prednisone (delta-cortisone), beclomethasone inhaler, ipratroprium inhaler, and salbutamol inhaler. During his ICU stay, he complained of nonspecific abdominal pain, interpreted as gastro-oesophageal reflux. After four days, he was discharged to the ward. On his sixth hospital day, he began to experience right-sided lower abdominal pain and right shoulder pain. A surgeon was consulted, and the patient was found to have a very tender right lower quadrant with guarding and rebound pain. He was therefore scheduled for appendicectomy; antibiotic therapy with ampicillin, gentamicin, and metronidazole was initiated. MESH: Adolescence-; Albuterol-administration-and-dosage; Albuterol-therapeutic-use; Appendectomy-methods; Asthma-complications; Asthma-physiopathology; Beclomethasone-administration-and-dosage; Beclomethasone-therapeutic-use; Bupivacaine-administration-and-dosage; Fentanyl-administration-and-dosage; Lidocaine-administration-and-dosage; Methylprednisolone-administration-and-dosage; Methylprednisolone-therapeutic-use; Morphine-administration-and-dosage; Pain,-Postoperative-prevention-and-control; Prednisone-administration-and-dosage; Prednisone-therapeutic-use MESH: *Anesthesia,-Epidural; *Appendectomy-; *Asthma-drug-therapy AN: 94349465 -------------------------------------------------------------------------------- Record 10 of 26 - MEDLINE (R) 1994 TI: Protective effect of albuterol delivered via a spacer device (Babyhaler) against methacholine induced bronchoconstriction in young wheezy children. AU: Avital-A; Godfrey-S; Schachter-J; Springer-C SO: Pediatr-Pulmonol. 1994 May; 17(5): 281-4 LA: ENGLISH AB: Nine young asthmatic children aged 2-5 years underwent methacholine challenge after placebo or albuterol administered by metered dose inhaler through a spacer device (Babyhaler) with a face mask in a double-blind, cross-over, randomized study. The methacholine challenge was performed using chest auscultation to define the provocative concentration of methacholine that causes wheezing (PCW). The PCW increased from a geometric mean of 0.28 mg/mL after placebo to 3.59 mg/mL after albuterol (P < 0.0001). The protective effect of albuterol against methacholine-induced bronchospasm was 3.7 +/- 1.2 doubling doses. We conclude that administration of drugs from a metered dose inhaler through the Babyhaler with a face mask is effective. Albuterol causes a major reduction in the bronchial hyperreactivity in young wheezy children shortly after administration. MESH: Asthma-physiopathology; Child,-Preschool; Double-Blind-Method; Respiratory-Sounds MESH: *Albuterol-administration-and-dosage; *Asthma-drug-therapy; *Bronchial-Provocation-Tests; *Bronchoconstriction-drug-effects; *Methacholine-Chloride-diagnostic-use; *Nebulizers-and-Vaporizers AN: 94336321 -------------------------------------------------------------------------------- Record 11 of 26 - MEDLINE (R) 1994 TI: Adenosine in the termination of albuterol-induced supraventricular tachycardia. AU: Cook-P; Scarfone-RJ; Cook-RT SO: Ann-Emerg-Med. 1994 Aug; 24(2): 316-9 LA: ENGLISH AB: Five percent of children in the United States have asthma. Status asthmaticus is one of the most common conditions for which children seek care in a pediatric emergency department. beta 2-Agonists such as albuterol are the mainstay of emergency therapy for such children. We present a case of a 4-year-old boy who experienced supraventricular tachycardia (SVT) following albuterol therapy. This is believed to be the first report of adenosine being successfully used to treat a child with albuterol-induced SVT. We also briefly review the recognition and management of SVT in children and the pharmacokinetics of and indications for adenosine. MESH: Child,-Preschool; Status-Asthmaticus-drug-therapy; Tachycardia,-Supraventricular-drug-therapy MESH: *Adenosine-therapeutic-use; *Albuterol-adverse-effects; *Tachycardia,-Supraventricular-chemically-induced AN: 94311526 -------------------------------------------------------------------------------- Record 12 of 26 - MEDLINE (R) 1994 TI: [Evaluation of the efficacy and safety of mepifylline in oral solution in children with mild and moderate asthmatic crises] AU: Sienra-Monge-JJ; Prieto-Ursua-L; Gerardo-Sol-Monterrey-E; Estela-del-Rio-Navarro-B; Paredes-Novelo-MC SO: Allergol-Immunopathol-Madr. 1994 Jan-Feb; 22(1): 3-8 LA: SPANISH; NON-ENGLISH AB: Efficacy and safety of mepiphylline, a derivative of theophylline, was evaluated in a group of children, aged 6 to 10 years, with mild or moderate acute asthma. A parallel, randomized, double-blind, placebo controlled, prospective study was performed in 40 children. Twenty one of them received mepiphylline in dose of 8 mg/kg/dia divided in 3 during 10 days, and 19 (control group) received placebo. Salbutamol aerosols were available in both groups. Clinical and spirometric data were collected before the beginning of the treatment (pre-and-post-nebulized salbutamol), and at the 3rd, 7th and 10th days. Children and parents cooperated with a diary of symptoms, peak-flow measurements and account of salbutamol used. A total relief of symptoms was found in 14 patients in the mepiphylline group and just 8 of the control group, with no significant differences. Neither spirometry nor diary data showed significant differences. Salbutamol was less than 3 days of unnecessary in 13 patients (61.9%) in the mepiphylline group and 8 patients (42.1%) in the control group (p < 0.05; Kolmogorov-Smirnov two samples Test). We conclude that mepiphylline could be a complementary treatment of mild and moderate acute asthma with a good safety in children. MESH: Administration,-Oral; Albuterol-administration-and-dosage; Child-; Double-Blind-Method; Drug-Therapy,-Combination; English-Abstract; Prospective-Studies; Pyrilamine-administration-and-dosage; Pyrilamine-adverse-effects; Pyrilamine-therapeutic-use; Respiratory-Function-Tests; Safety-; Theophylline-administration-and-dosage; Theophylline-adverse-effects; Theophylline-therapeutic-use; Treatment-Outcome MESH: *Asthma-drug-therapy; *Pyrilamine-analogs-and-derivatives; *Theophylline-analogs-and-derivatives AN: 94303609 -------------------------------------------------------------------------------- Record 13 of 26 - MEDLINE (R) 1994 TI: Beta-agonist inhaler causing hallucinations. AU: Schnapf-BM; Santeiro-ML SO: Pediatr-Emerg-Care. 1994 Apr; 10(2): 87-8 LA: ENGLISH AB: This report describes a precocious eight-year-old child who presented with hallucinations from excessive use of albuterol inhalers. Shifting the child to a powdered form of albuterol (without the fluorocarbon propellant) controlled his asthma, and his behavior improved rapidly. The potential harmful effects of fluorocarbons used as propellants for inhalers are discussed. MESH: Asthma-drug-therapy; Child-; Powders- MESH: *Albuterol-administration-and-dosage; *Freons-adverse-effects; *Hallucinations-chemically-induced; *Nebulizers-and-Vaporizers; *Substance-Abuse AN: 94301896 -------------------------------------------------------------------------------- Record 14 of 26 - MEDLINE (R) 1994 TI: [Bronchial asthma in a pediatric emergency service] AU: Canciani-M; Marchi-AG SO: Pediatr-Med-Chir. 1994 Jan-Feb; 16(1): 25-7 LA: ITALIAN; NON-ENGLISH AB: The aim of this study was to assess the prevalence, clinical patterns and treatment of asthma in a well-defined area near the North East Italian border (Province of Trieste, 212 kmq, 30,000 inhabitants aged 0-15 years), served by only one children's hospital. The study was carried out from January to December 1991, in the Emergency Department (ED). 118 patients aged from 3 months to 16 years (mean age 5 years) presented bronchial asthma (0.7% of total ED consultation, 6.2% of acute respiratory tract disease). 29 (24.6%) were first diagnosis, 89 (75.4%) were formerly diagnosed. 57% of patients came to the ED in autumn and winter, 36% in spring and 7% in summer; 19.5% of patients came to the ED during the night. Main presentation symptoms were cough (66%), dyspnea (46%), fever (24%). Treatment consisted of aerosolized salbutamol (50%), associated with oral corticosteroids (31%), iv corticosteroids (3%), aerosolized beclomethasone (10%); 6% of patients received only oral salbutamol. 21 patients were hospitalized, all but one in the ED. In all cases hospitalization lasted less than 2 days and therapy was similar to that of non hospitalized patients, except for administration of aminophylline and iv corticosteroid in 5% of patients. ED consultation and hospitalization for bronchial asthma are low in our area, probably due to good working of the Allergologic Centre and to good connection of this structure with paediatricians. MESH: Administration,-Oral; Adolescence-; Adrenal-Cortex-Hormones-administration-and-dosage; Aerosols-; Age-Factors; Albuterol-administration-and-dosage; Aminophylline-administration-and-dosage; Asthma-diagnosis; Asthma-drug-therapy; Beclomethasone-administration-and-dosage; Child-; Child-Health-Services; Child,-Preschool; Emergency-Medical-Services; English-Abstract; Hospitalization-; Infant-; Injections,-Intravenous; Length-of-Stay MESH: *Asthma-therapy AN: 94301863 -------------------------------------------------------------------------------- Record 15 of 26 - MEDLINE (R) 1994 TI: Asthma: audit of peak flow rate guidelines for admission and discharge. AU: Taylor-MR SO: Arch-Dis-Child. 1994 May; 70(5): 432-4 LA: ENGLISH AB: A two part 8.5 month study was undertaken to see if peak expiratory flow rate (PEFR) could be used to guide casualty officers deciding whether to admit or discharge children with asthma. In part 1 PEFR, immediate treatment, and admission or discharge of all children attending because of asthma were recorded. In part 2 the same information was recorded after the introduction of admission and discharge guidelines based on PEFR. After the introduction of guidelines the proportion of children admitted with a PEFR > or = 40% expected after casualty treatment fell from 43% to 26% (part 1 44/101, part 2 38/145). For a PEFR > 60% the rate fell from 23% to 5% (part 1 12/52, part 2 4/80). There was no significant change in the reattendance rate. PEFR can help to reduce unnecessary admissions, provided appropriate normal values and guidelines are supplied. MESH: Adolescence-; Albuterol-therapeutic-use; Asthma-drug-therapy; Child-; Child,-Preschool; Medical-Audit; Patient-Admission; Patient-Discharge; Practice-Guidelines MESH: *Asthma-physiopathology; *Peak-Expiratory-Flow-Rate AN: 94288675 -------------------------------------------------------------------------------- Record 16 of 26 - MEDLINE (R) 1994 TI: Metered-dose inhalers for young athletes with exercise-induced asthma. Committee on Sports Medicine and Fitness. American Academy of Pediatrics. SO: Pediatrics. 1994 Jul; 94(1): 129-30 LA: ENGLISH MESH: Adolescence-; Child-; Wrestling- MESH: *Albuterol-administration-and-dosage; *Asthma,-Exercise-Induced-drug-therapy; *Cromolyn-Sodium-administration-and-dosage; *Nebulizers-and-Vaporizers; *Sports- AN: 94277723 -------------------------------------------------------------------------------- Record 17 of 26 - MEDLINE (R) 1994 TI: Pediatric management problems. Asthma. AU: Smith-DY SO: Pediatr-Nurs. 1994 May-Jun; 20(3): 258-9 LA: ENGLISH MESH: Administration,-Inhalation; Asthma-complications; Child-; Hypersensitivity-complications; Parents-education; Patient-Education MESH: *Albuterol-administration-and-dosage; *Asthma-drug-therapy AN: 94277673 -------------------------------------------------------------------------------- Record 18 of 26 - MEDLINE (R) 1994 TI: Low-dose beta-agonist continuous nebulization therapy for status asthmaticus in children. AU: Montgomery-VL; Eid-NS SO: J-Asthma. 1994; 31(3): 201-7 LA: ENGLISH AB: The role of continuous nebulization therapy (CNT) with low-dose beta (beta) agonist was retrospectively reviewed in 7 children admitted to a pediatric intensive care unit for treatment of acute severe asthma. Clinical asthma score (CAS), alveolar-arterial oxygen difference (A-aDO2), PaCO2, heart rate, and respiratory rate were recorded at 0, 12, and 24 hr of CNT. All patients had a decrease in CAS at 12 hr (p < 0.008) and decreased A-aDO2, PaCO2, respiratory rate, and heart rate at 24 hr (p < 0.008). No patient required escalation of dosage or additional intervention such as intravenous beta-agonist therapy or mechanical ventilation. No patient experienced significant cardiovascular toxicity or hypokalemia. We conclude that CNT with low-dose beta agonists should be considered in the initial approach to therapy in children with acute severe asthma. MESH: Administration,-Inhalation; Adolescence-; Aerosols-; Albuterol-adverse-effects; Child-; Child,-Preschool; Isoproterenol-adverse-effects; Retrospective-Studies; Status-Asthmaticus-physiopathology MESH: *Albuterol-administration-and-dosage; *Isoproterenol-administration-and-dosage; *Status-Asthmaticus-drug-therapy AN: 94252972 -------------------------------------------------------------------------------- Record 19 of 26 - MEDLINE (R) 1994 TI: Effect of nebulized ipratropium bromide on intraocular pressures in children. AU: Watson-WT; Shuckett-EP; Becker-AB; Simons-FE SO: Chest. 1994 May; 105(5): 1439-41 LA: ENGLISH AB: STUDY OBJECTIVE: To evaluate the effects of nebulized ipratropium bromide on intraocular pressures and pupillary responses in children with asthma. DESIGN: A double-blind, randomized, crossover study. SETTING: Children's Hospital of Winnipeg, University of Manitoba. PATIENTS OR PARTICIPANTS: Age 6 to 17 years with asthma. INTERVENTION: Nebulized ipratropium bromide added to albuterol sulfate, albuterol alone, or saline solution was given by face mask and nebulizer. Before and 0.5 h after nebulization, intraocular pressures (mm Hg), pupillary size (mm), and pupillary responses were measured. In a subsequent open study, patients who had been admitted to hospital with acute asthma who were treated with nebulized ipratropium bromide were recruited for measurement of intraocular pressures, pupillary size, and pupillary responses. MEASUREMENTS AND RESULTS: Twenty patients completed the double-blind study, and 26 patients completed the open study. There were no changes in intraocular pressures, pupillary size, or pupillary response after any treatment on any study day in either the double-blind or the open studies. CONCLUSION: In children with asthma, who have no pre-existing ocular abnormalities, the risk of an adverse reaction to nebulized ipratropium bromide delivered by face mask inadvertently absorbed in the eye is extremely small. MESH: Adolescence-; Aerosols-; Albuterol-administration-and-dosage; Asthma-drug-therapy; Asthma-physiopathology; Child-; Double-Blind-Method; Drug-Therapy,-Combination; Ipratropium-administration-and-dosage; Pupil-drug-effects MESH: *Intraocular-Pressure-drug-effects; *Ipratropium-adverse-effects AN: 94237004 -------------------------------------------------------------------------------- Record 20 of 26 - MEDLINE (R) 1994 TI: Home nebulizer therapy in asthmatics in Qatar. AU: Osundwa-VM; Dawod-ST; Ehlayel-MS SO: J-Asthma. 1994; 31(1): 51-3 LA: ENGLISH AB: We reviewed charts of 50 asthmatic children who were on home nebulizer therapy for treatment of their asthma over a 1-year period. Patients served as their own controls for comparison of the asthma-related variables between periods of 6 months before and 6 months after the initiation of home nebulizer treatment. There was a 74% and 70% reduction in the emergency room visits and hospitalizations, respectively, during the period when the patients were on home nebulizer therapy. We suggest that this form of therapy, if properly used in appropriately selected asthmatic children, will reduce the need for hospital care. MESH: Albuterol-therapeutic-use; Asthma-epidemiology; Bronchodilator-Agents-therapeutic-use; Child,-Preschool; Emergency-Service,-Hospital-utilization; Home-Nursing; Hospitalization-; Qatar-epidemiology; Retrospective-Studies MESH: *Albuterol-administration-and-dosage; *Asthma-drug-therapy; *Bronchodilator-Agents-administration-and-dosage; *Nebulizers-and-Vaporizers AN: 94230277 -------------------------------------------------------------------------------- Record 21 of 26 - MEDLINE (R) 1994 TI: A multicentre comparison of the efficacy of terbutaline Turbuhaler and salbutamol pressurized metered dose inhaler in hot, humid regions. AU: Lindsay-DA; Russell-NL; Thompson-JE; Warnock-TH; Shellshear-ID; Buchanan-PR SO: Eur-Respir-J. 1994 Feb; 7(2): 342-5 LA: ENGLISH AB: Twenty seven adults and 20 children with previously diagnosed stable asthma, using a salbutamol pressurized metered dose inhaler (P-MDI) and living in Cairns, Townsville and Southport, Queensland, Australia participated in a randomized, open-label cross-over comparison of terbutaline administered via Turbuhaler and salbutamol administered via P-MDI. The aim of the study was to compare the clinical effectiveness and patient acceptance of the two treatments in hot, humid regions. Terbutaline was administered via Turbuhaler and salbutamol via P-MDI on at least two occasions per day during each four week treatment period. Spirometry was performed at the start of the study, after the two week run-in and at the end of each treatment period. Patients used diary cards to record morning and evening peak expiratory flows, daily symptom scores and daily intake of beta 2 agonist medication. At the end of the study, patients answered a treatment preference question. Forty six patients completed the study. No statistically significant differences were observed between the two treatments in peak expiratory flow, change in morning peak expiratory flow pre- and post-beta-agonist, daily symptom scores, diurnal variability and spirometry. Forty four percent of patients preferred the terbutaline Turbuhaler and 39% preferred salbutamol P-MDI. Both agents were similarly tolerated. Terbutaline delivered by Turbuhaler is as clinically effective as salbutamol delivered by P-MDI in patients with asthma living in hot, humid regions. MESH: Aerosols-; Albuterol-therapeutic-use; Child-; Middle-Age; Patient-Acceptance-of-Health-Care; Queensland-; Terbutaline-therapeutic-use MESH: *Albuterol-administration-and-dosage; *Asthma-drug-therapy; *Heat-; *Humidity-; *Nebulizers-and-Vaporizers; *Terbutaline-administration-and-dosage AN: 94215677 -------------------------------------------------------------------------------- Record 22 of 26 - MEDLINE (R) 1994 TI: Patient handling of a multidose dry powder inhalation device for albuterol. AU: Kesten-S; Elias-M; Cartier-A; Chapman-KR SO: Chest. 1994 Apr; 105(4): 1077-81 LA: ENGLISH AB: BACKGROUND: Studies have suggested that novel inhaling devices may be misused by patients and medical personnel in the clinical setting soon after their introduction. to assess the adequacy of patient handling of a newer multidose dry powder albuterol inhaler, we conducted a comprehensive survey of use in primary and respiratory practices. METHODS: Patients 6 years of age and older and requiring inhaled beta 2-agonist for the treatment of stable obstructive airways disease were recruited from the practices of primary care and specialist physicians. After instruction from their physician or clinic staff in the use of a multidose dry powder albuterol inhalation device (Diskhaler), patients used the device in unblinded fashion for 2 weeks instead of their usual beta 2-agonist. After 2 weeks, patient use of the device was assessed at a return clinic visit. RESULTS: A total of 4,529 patients with reversible airways obstruction participated in a 2-week assessment of the device and compared it with their previous beta 2-agonist delivery system. Significantly more patients preferred the dry powder device (54 percent) over their previous device (29 percent) (p < 0.001), with 17 percent expressing no preference. After instruction, 98.5 percent of patients could demonstrate adequate use at the initial visit. Performance difficulties at the initial visit resulting in exclusion from the trial were infrequent but more common in the elderly (3 percent vs 0.2 percent for all other age groups combined, p < 0.001). Despite adequate use at the initial visit, at the conclusion of the trial, incorrect use of the device was noted in 10.2 percent of the elderly vs 3.2 percent of all other age groups combined (p < 0.001). Albuterol delivered by Diskhaler was well tolerated in all patient groups. CONCLUSIONS: A majority of patients are able to use a multidose dry powder albuterol inhaler device in the clinical setting, and prefer the device to previously used beta 2-agonist inhalation devices. However, follow-up shows that problems with device handling may become apparent in as little as 2 weeks after initial instruction, thereby mandating the need for periodic follow-up and reinstruction. MESH: Administration,-Inhalation; Adolescence-; Adult-; Aged-; Albuterol-adverse-effects; Asthma-drug-therapy; Child-; Middle-Age; Nebulizers-and-Vaporizers; Patient-Compliance; Patient-Satisfaction; Powders- MESH: *Albuterol-administration-and-dosage AN: 94215345 -------------------------------------------------------------------------------- Record 23 of 26 - MEDLINE (R) 1994 TI: Prednisolone and salbutamol in the hospital treatment of acute asthma. AU: Connett-GJ; Warde-C; Wooler-E; Lenney-W SO: Arch-Dis-Child. 1994 Mar; 70(3): 170-3 LA: ENGLISH AB: The use of oral prednisolone (2 mg/kg) to treat children admitted to hospital with acute asthma was assessed in a placebo controlled study. Children were further randomised to receive either 0.15 mg/kg salbutamol every 30 minutes for the first three hours of admission, or 5 mg salbutamol every one to four hours as needed. Treatment was double blind and the assessor was unaware of the nebuliser regimen given. Children were examined before and after treatment with salbutamol on arrival and reassessed four hours after admission. Seventy children completed the study. Seventeen (46%) of 37 children receiving prednisolone and six (9%) of 33 receiving placebo were fit for discharge after four hours of treatment. There was no significant difference between the two nebuliser regimens. Clinical parameters indicative of asthma severity were improved in all groups. Between group comparisons at reassessment showed higher peak flows in those receiving prednisolone and nebulisers every 30 minutes but differences were not significant for other parameters. Objective parameters indicating steroid efficacy over placebo were minimal. Despite this, those receiving prednisolone were more readily identifiable as being fit for discharge within four hours of treatment. MESH: Acute-Disease; Administration,-Inhalation; Administration,-Oral; Child-; Child,-Preschool; Double-Blind-Method; Drug-Administration-Schedule; Drug-Therapy,-Combination; Emergencies-; Infant- MESH: *Albuterol-administration-and-dosage; *Asthma-drug-therapy; *Prednisolone-administration-and-dosage AN: 94182960 -------------------------------------------------------------------------------- Record 24 of 26 - MEDLINE (R) 1994 TI: Aminophylline therapy does not improve outcome and increases adverse effects in children hospitalized with acute asthmatic exacerbations. AU: Strauss-RE; Wertheim-DL; Bonagura-VR; Valacer-DJ SO: Pediatrics. 1994 Feb; 93(2): 205-10 LA: ENGLISH AB: OBJECTIVE. To evaluate the effects of aminophylline (Am) in children hospitalized with asthma. METHODS. Prospective, randomized, double-blind, placebo-controlled trial. Subjects were children between the ages of 5 and 18 years admitted for asthma exacerbation to either a tertiary care children's hospital or an inner-city general hospital in New York. Exclusion criteria were admission to the intensive care unit, initial theophylline level > 5 micrograms/dL, or the presence of other systemic disorders. All patients received nebulized albuterol therapy and intravenous glucocorticosteroids in standardized doses. Thirty-one patients were randomized to receive either an Am bolus followed by continuous Am infusion or placebo (P) bolus and infusion. The outcome variables were: duration of hospitalization, percent of predicted peak expiratory flow rates recorded at 12-hour intervals, number of albuterol treatments required, and adverse effects. RESULTS. There were no significant differences at study entry in age, sex, race, number of previous hospital admissions, prior medications used, clinical symptom scores, or initial peak flow rates for the two groups. For 26 patients who completed this study, 15 patients in the P group were hospitalized for a mean duration of 2.33 +/- 1.3 days, whereas 11 patients in the Am group required 2.58 +/- 1.5 days. There were no significant differences between the two groups for hospital days, peak flow rates at any time interval, or amount of albuterol therapy required (P > .2). In the Am group, 6 of the 14 patients who entered the study experienced significant adverse effects consisting of nausea, emesis, headache, abdominal pain, and palpitations. Only 1 of 17 patients in the P group had an adverse effect (P < .05). CONCLUSIONS. There is no benefit and considerable risk of adverse effects associated with the use of Am in hospitalized asthmatic children. MESH: Acute-Disease; Adolescence-; Albuterol-therapeutic-use; Aminophylline-adverse-effects; Child-; Child,-Preschool; Double-Blind-Method; Drug-Therapy,-Combination; Hospitalization-; Length-of-Stay; Methylprednisolone-therapeutic-use; Prospective-Studies; Treatment-Outcome MESH: *Aminophylline-therapeutic-use; *Asthma-drug-therapy AN: 94167167 -------------------------------------------------------------------------------- Record 25 of 26 - MEDLINE (R) 1994 TI: Effect of salbutamol on gas compression in cystic fibrosis and asthma. AU: Desmond-KJ; Demizio-DL; Allen-PD; MacDonald-ND; Coates-AL SO: Am-J-Respir-Crit-Care-Med. 1994 Mar; 149(3 Pt 1): 673-7 LA: ENGLISH AB: In cystic fibrosis (CF), it has been suggested that increases in FEV1 postbronchodilator (BD) can be accompanied by paradoxical decreases in isovolume maximal flow at 25% of vital capacity (V25iso) measured from maximum expiratory flow-volume curves (MEFVC), raising concerns about determining the benefits of BD in CF. MEFVC measured using expired volume has been shown to be subject to errors due to gas compression. In the present study, BD response was assessed in 91 patients with asthma and 78 with CF using the percentage of change in FEV1 and V25iso determined using MEFVC from both mouth (m) and plethysmograph (p) volumes. From the two curves, volume of compression (Vcomp) was measured. Baseline measurements were similar for both groups, except that the residual volume to total lung capacity ratio (RV/TLC) was higher and Vmax25 and FVC were lower in CF. Both groups showed significant (p < 0.05) increases in FVC, FEV1, and V25iso after BD. The percentage of change in FEV1 correlated with the percentage of change in V25iso (r = 0.53 for CF and 0.66 for asthma, p < 0.001). Baseline Vcomp25 was higher in asthma than in CF. The percentage of change in V25iso was not related to the change in Vcomp25iso for either group. Only four patients with CF showed a paradoxical decrease in V25iso, and the differences in flow were small. Two had an increase in Vcomp and two had a decrease. We conclude that paradoxical decreases in V25iso are rare, are associated with small changes in flow, and are not related to changes in Vcomp.(ABSTRACT TRUNCATED AT 250 WORDS) MESH: Adolescence-; Albuterol-pharmacology; Asthma-classification; Bias-Epidemiology; Child-; Cystic-Fibrosis-classification; Plethysmography-; Residual-Volume-drug-effects; Severity-of-Illness-Index; Spirometry- MESH: *Albuterol-therapeutic-use; *Asthma-drug-therapy; *Asthma-physiopathology; *Cystic-Fibrosis-drug-therapy; *Cystic-Fibrosis-physiopathology; *Forced-Expiratory-Volume-drug-effects; *Maximal-Expiratory-Flow-Volume-Curves-drug-effects; *Vital-Capacity-drug-effects AN: 94163419 -------------------------------------------------------------------------------- Record 26 of 26 - MEDLINE (R) 1994 TI: A cohort analysis of excess mortality in asthma and the use of inhaled beta-agonists. AU: Suissa-S; Ernst-P; Boivin-JF; Horwitz-RI; Habbick-B; Cockroft-D; Blais-L; McNutt-M; Buist-AS; Spitzer-WO SO: Am-J-Respir-Crit-Care-Med. 1994 Mar; 149(3 Pt 1): 604-10 LA: ENGLISH AB: The association between the use of inhaled beta-agonists and the risk of death and near-death from asthma has previously been reported. It was based on a nested case-control study of 129 cases and 655 control subjects selected from a cohort of 12,301 users of asthma drugs followed during the period 1980 through 1987. In this paper we examine the question of asthma and non-asthma mortality using data from the entire cohort of 12,301 asthmatics. There were 46 asthma and 134 non-asthma deaths in this cohort, for which there were 47,842 person-years of follow-up. The overall rate of asthma death was 9.6 per 10,000 asthmatics per year. This rate varied significantly according to the use of fenoterol, albuterol, or oral corticosteroids in the prior 12 months and the number of asthma hospitalizations in the prior 2 years. The rate decreased significantly, by 0.6 asthma deaths per 10,000 asthmatics per year over the study period, after controlling for the effect of the four other risk factors. It also increased significantly with the use of all beta-agonists, and more so for fenoterol than for albuterol, although this difference was partly explained by the dose inequivalence of the two drugs. Change-point dose-response curves showed that the risk of asthma death began to escalate drastically at about 1.4 canisters (of 20,000 micrograms each) per month of inhaled beta-agonist, the recommended limit. For non-asthma death, the overall rate of 28 deaths per 10,000 asthmatics per year was not related to the use of inhaled beta-agonists.(ABSTRACT TRUNCATED AT 250 WORDS) MESH: Administration,-Inhalation; Administration,-Oral; Adolescence-; Adrenal-Cortex-Hormones-administration-and-dosage; Adult-; Cause-of-Death; Child-; Child,-Preschool; Dose-Response-Relationship,-Drug; Drug-Therapy,-Combination; Follow-Up-Studies; Hospitalization-statistics-and-numerical-data; Linear-Models; Middle-Age; Odds-Ratio; Risk-Factors; Saskatchewan-epidemiology; Socioeconomic-Factors; Survival-Analysis MESH: *Albuterol-administration-and-dosage; *Albuterol-adverse-effects; *Asthma-drug-therapy; *Asthma-mortality; *Fenoterol-administration-and-dosage; *Fenoterol-adverse-effects; *Population-Surveillance AN: 94163407