Asthma inhaler

An asthma inhaler is an example of a product that contains both a drug and a drug delivery device. Such a product would be regulated primarily as a drug as it achieves its medical purpose by pharmaceutical means. The inhaler would additionally have to satisfy the requirements of a device. 

I . Steal and hide a friend s asthma inhaler as a joKe. 

In persistent asthma, inhaled corticosteroids provide the most comprehensive control of the inflammatory process. 

In persistent asthma, inhaled corticosteroids provide the most comprehensive control of the inflammatory process and are the cornerstone of therapy.2 Inhaled corticosteroids are more effective than cromolyn, leukotriene modifiers, nedocromil, and theophylline in reducing markers of inflammation and AHR, improving lung function, and preventing emergency department visits and hospitalizations due to asthma exacerbations.2,25 The primary... 

Amphetamines Appetite suppressants Asthma inhalants Buspirone Carbamazepine Cocaine... 

Chronic exposure to fumes of heated glacial acetic acid in a canning factory has been associated with a late airway response resulting in chronic inflammation and severe bronchial asthma. Inhalation challenge induced a late asthmatic response, confirming sensitization. ... 

Bronchial asthma (inhalation solution, aerosol) As prophylactic management of bronchial asthma. Cromolyn is given on a regular, daily basis in patients with frequent symptomatology requiring a continuous medication regimen. 

Based on the concept that asthma is an inflammatory disease that leads to airway obstruction, inhaled glucocorticoids are the first-line treatment for moderate to severe asthma. Inhaled preparations are particularly effective when used to prevent recurrent attacks. This therapy is often combined with an inhaled bron-chodUator such as a p-adrenergic agonist. The use of p-adrenergic agonists or theophylline enables use of a lower dose of glucocorticoid, especially in patients relatively resistant to therapy (see Chapter 39). 

Bronchial asthma Inhalation Initially, 200-400 meg twice a day. Maximum 800 meg twice a day. 

Asthma Inhalation (nebulization) 20 mg 3-4 times a day. Aerosol Spray Initially, 2 sprays 4 times a day. Maintenance 2-4 sprays 3-4 times a day. 

Asthma-. Inhalation Initially, inhale 220 mqj (1 puff) once a day. Maximum 880 meg once a day... 

Equivalence trials are, of course, routinely used in the evaluation of bioequivalence and the methodology there is well established, both European and FDA guidelines exist. More recently we have seen the need to establish therapeutic equivalence and Ebbutt and Frith (1998) provide a detailed case study in the development of an alternative propellant for the asthma inhaler. More usually,... 

Albuterol Activates adenylyl cyclase Bronchial smooth muscle dilation Asthma Inhalation duration 4-6 h Toxicity Tremor, tachycardia... 

The monofunctional tryptase inhibitor APC-366 (Axys Pharmaceuticals) reduces the acute airway response and histamine release to allergen in a pig model of allergen-induced asthma [19]. APC-366 is also effective in a sheep model of allergen-induced asthma but was only poorly effective in asthma patients (proof-of-principle) [8], The compound was in clinical development phase II for asthma (inhalative). Although highly selective for tryptase over plasmin and plasma kal-likrein, APC-366 was not selective against thrombin and trypsin [13], Another monofunctional tryptase inhibitor is bis(5-amidino-2-benzimidazol-yl)methane (BABIM) which has been shown to be effective in the sheep. Further development of the compound was, however, discontinued, maybe because of the lack of selectivity over trypsin [13, 16, 17] (Figure 3.2.2). 

The example we will consider in detail is a company that produces pressurized canisters of drug for asthma inhalers. Their factory has two machines that manufacture the canisters. One machine (Allegro model) is faster and produces 61 per cent of the factory s output. The slower machine (Andante model) produces the other 39 per cent. Occasional canisters are returned as faulty, and over the previous year, 126 of these have accumulated. From the batch numbers on the canisters we can determine that 52 were manufactured on the Allegro machine and 74 on the Andante. Since only a minority of canisters are made on the Andante machine, and yet it generates the majority of returns, we suspect that the output from this machine is less reliable. However, a formal statistical test is required. 

A Salmeterol, also a p2 agonist, has a slow onset of action and is not used in acute asthmatic attacks. B, E Cromolyn and nedocromil are used prophylacticlly, but are not effective in acute asthma. C Beclomethasone is an anti-inflamatory agent indicated for moderate to severe asthma. Inhaled beclomethasone reduces airway inflammation but its actions are not immediate the drug is administered chronically, but it is not effective in the treatment of an acute asthmatic attack. 

Beclomethasone dipropionate is a corticosteroid with mainly glucocorticoid activity that is started to exert a topical effect on the lungs, without significant systemic activity. It is used by inhalation, generally from a metered-dose aerosol, for the prophylaxis of asthma. Inhalation of nebulized beclomethasone dipropionate has also been used in the management of asthma in children. 

Patient education is vital for the management of asthma. Patients should be guided in their use of the asthma inhaler. It is important that you then observe the patient s use. Instructions given to the patient are as follows ... 

Adults and adolescents with asthma Inhalation 0.12-4 ppm 40 min - 4 h No change in pulmonary function was noted in several studies of adult and adolescent, whether at rest or with intermittent exercise. Koenig et al. 1987 Koenig et al. 1985 Kleinman et al. 1983 Rubinstein et al. 1990 Vagaggini et al. 1996 Utell and Morrow 1989 Mohsenin 1987 Roger et al. 1990 Sackneret al. 1981 Linn and Hackney 1984... 

Encourage patients purchasing nonprescription asthma inhalers or tablets to seek medical care. 

Over-the-counter medications to avoid include cough and cold preparations, including those containing dextromethorphan, nasal decongestants (tablets, drops, or spray), hay-fever medications, sinus medications, asthma inhalant medications, anti-appetite medications, weight reducing preparations, pep pills... 

Anonymous. 3M first with a CFC-free asthma inhaler. Pharm ] 1995 254 388. 

Where it would be impractical to split a package (so long as the package has been made up in a container elsewhere than at the place of sale or supply), for example, an emergency supply of an asthma inhaler. 

Hatch GE Asthma, inhaled oxidants, and dietary antioxidants. Am J Clin Nutr 1995 61... 

Budesonide is a corticosteroid/flucocorticoid/intranasal steroid. It exhibits a wide range of inhibitory activities against multiple cell types and mediators involved in aller-gic-mediated inflammation. Its indications are Intranasal management of seasonal and perennial allergic rhinitis symptoms in adults and children oral inhalation for the maintenance treatment of asthma as prophylactic therapy in adults and children and for patients requiring oral corticosteroid therapy for asthma inhalation suspension maintenance treatment of asthma and prophylactic therapy in children 12 months to 8 years of age oral capsule Crohn s disease. 

---