COPD Category

Because each patient was compared with himself, it was hoped that factors such as concurrent bronchodilator therapy and individual differences in bronchodilator responsiveness would not obscure differential responses to the type of bronchodilator administration. It is unlikely that over the six-hour period theophylline levels, etc, would vary enough to substantially effect the results. Indeed, the […]

The dose of albuterol that we chose for the nebulizer is the standard recommended dose, while that chosen for the MDI-spacer system was twice the usual dose. In the study of Jenkins et al, cumulative dose-response curves were generated to establish the doses of albuterol (salbutamol) by MDI and nebulizer which produced maximum bronchodilation in […]

Two previous studies comparing nebulizer and MDI-spacer methods in acute exacerbations of COPD were also unable to demonstrate a difference in efficacy but did not employ a crossover design. Jasper et al compared delivery of metaproterenol by nebulizer (15 mg) and MDI-spacer (two puffs; 1.3 mg) in a mixed population of patients with asthma and […]

Many patients have difficulty employing the proper technique for using MDIs. Spacer/reservoir systems circumvent some of these difficulties. With proper use of MDIs, a much smaller dose of drug than that administered by nebulizer is equipotent for bronchodilation. However, patients with acute exacerbations of COPD are frequently tachypneic, and this makes optimal use of MDIs […]

In addition, there was large variability in the percent change in the FEVi that individual subjects exhibited after the two treatments (Fig 2). Analysis of the effect of the order with which active medication was delivered by MDI-spacer (group 1 vs 2) showed no effect of this factor on the FEV, values or Borg scores […]

The 20 male patients participating in the study had an age range of 60 to 91 years, with a mean of 67.9 ± 7.1 years. Their spirometry on admission showed an FEVi of 0.71 ±0.26 L, an FVC of 1.77±0.52 L, and an FEVi/FVC ratio of a 0.41 ±0.11. Thus, the patients were quite elderly […]

Monitoring On admission, spirometry, an arterial blood gas analysis, a chest roentgenogram, and determination of the theophylline level were done. Spirometric data (Vitalograph) and a Borg dyspnea score were obtained before each treatment block and 1 h after nebulizer inhalation was begun (referred to as 1 h after treatment). The best values for FEV, and […]