PRS49 All-Cause 30-Day Readmissions for Matched Inpatients with Copd Receiving Nebulized Short-Acting or Long-Acting Beta Agonists

Inhaled short-acting bronchodilators (beta-agonists and M-anticholinergics) have been used for a long time in patients with bronchoobstructive diseases, the main representatives of which are chronic obstructive pulmonary disease (COPD) and bronchial asthma (BA). Given the fact that most patients with COPD and BA are treated with long-acting bronchodilators, the question arises about the place of short-acting drugs in modern treatment algorithms for bronchoobstructive pathology. The data on how many patients take short-acting beta-agonists and M- anticholinergics in real-life clinical practice, and how appropriate it is to use these drugs on top of prolonged drugs are provided. The Russian part of the international POPE-study analyzed the characteristics of outpatients with COPD. It was found that the vast majority of patients have short-acting bronchodilators as part of their therapy, and more than 50% of patients receive a combination of SABA and SAAC, and in most cases this is represented by a combination of fenoterol + ipratropium. Taking into account that the majority of patients with COPD and asthma receive prolonged bronchodilators, important from a practical point of view is the question of the effectiveness of short-acting drugs on the background of prolonged ones. The article discusses these aspects of therapy and provides evidence that the use of SABA and SAAC provides an opportunity to achieve additional bronchodilatation when used against the background of prolonged bronchodilators. Thus, symptomatic use of SABA and SAAC on demand in bronchoobstructive pathology have sufficient justification even in the presence of a combination of prolonged bronchodilators in patient therapy. At the same time, it is necessary to take into account the increased probability of side effects with such drug regimen. The article also discusses the issues of different types of inhalation devices for short-acting bronchodilators (nebulizers and metered-dose aerosol inhalers), provides data on their comparative effectiveness and safety.

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Pharmacotherapies for COPD

Clinical Medicine Insights Circulatory Respiratory and Pulmonary Medicine ◽

10.4137/ccrpm.s7211 ◽

2013 ◽

Vol 7 ◽

pp. CCRPM.S7211 ◽

Cited By ~ 20

Author(s):

Stan Ejiofor ◽

Alice M. Turner

Keyword(s):

Inhaled Corticosteroids ◽

Review Article ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Short Acting ◽

Beta Agonists ◽

Drug Classes ◽

Pde Inhibitors ◽

Clinical Trial Results ◽

Long Acting

This review article summarizes the main treatments for chronic obstructive pulmonary disease, their mechanisms, and the key evidence from trials supporting their use. Drug classes covered were short acting beta agonists (SABA), short acting muscarinic antagonists (SAMA), long acting beta agonists (LABA), long acting antimuscarinics (LAMA), inhaled corticosteroids (ICS), LABA/ ICS combinations, specific phosphodiesterase (PDE4) inhibitors, non-specific PDE inhibitors, mucolytics, and oxygen. Non-specific therapies, such as opiates for relief of dyspnoea and therapies for smoking cessation, are also covered briefly. For each class of drug, mechanisms of action are described, key clinical trial results are reported, and available agents compared. Finally, the place of each drug in therapy is compared between current worldwide guidelines.

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Implementation of guideline-based therapy for chronic obstructive pulmonary disease: Differences between men and women veterans

Chronic Respiratory Disease ◽

10.1177/1479972317702141 ◽

2017 ◽

Vol 14 (4) ◽

pp. 385-391 ◽

Cited By ~ 5

Author(s):

Seppo T Rinne ◽

A Rani Elwy ◽

Chuan-Fen Liu ◽

Renda Soylemez Wiener ◽

Lisa Thayer ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Muscarinic Antagonists ◽

Obstructive Pulmonary Disease ◽

Men And Women ◽

Short Acting ◽

Beta Agonists ◽

Long Acting ◽

Va Hospitals

Chronic obstructive pulmonary disease (COPD) is common among both men and women, and guidelines recommend the same therapy for both sexes. While previous studies have identified gender differences in other chronic disease management, few studies have examined how implementation of COPD guidelines differs between men and women. We performed a cross-sectional study of veterans admitted to Veterans Affairs (VA) hospitals for COPD during October 1, 2008, to September 30, 2011. We collected information on baseline COPD medications during the 6 months prior to hospitalization and categorized therapies as “appropriate” or “inappropriate” based on current guidelines. We used multivariable logistic regression to examine the differences in COPD medications between men and women, after controlling for baseline patient characteristics. We also examined the differences in hospital outcomes, including length of stay and hospital readmission. We identified 33,558 veterans, including 1149 women and 32,409 men who were admitted to 130 VA hospitals. Women were significantly less likely to have received inhaler therapies prior to admission, with lower rates of short-acting beta agonists, short-acting muscarinic antagonists, long-acting beta agonists, and long-acting muscarinic antagonists compared to men. Women also received fewer appropriate inhaler combinations (odds ratio [OR] = 0.83, 95% confidence interval [CI] 0.74–0.93) and more inappropriate combinations (OR = 1.33, 95% CI 1.17–1.51). Women and men were prescribed similar rates of inhaled steroid and oral steroids. Hospital outcomes were also similar between the two groups. These findings highlight a potential gender disparity in appropriate outpatient COPD therapy. Improving the quality of care for patients with COPD should include equitable implementation of guideline-based COPD management.

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Camel milk in asthmatic children: a double blind randomized clinical trial

10.21203/rs.3.rs-269628/v1 ◽

2021 ◽

Author(s):

Elham Bakhtiari ◽

Soudabeh Nekouhi ◽

Saeid Zibaee ◽

Hasan Rakhshandeh ◽

Seyed Javad Sayedi

Keyword(s):

Clinical Trial ◽

Inhaled Corticosteroids ◽

Camel Milk ◽

P Value ◽

Double Blind ◽

Short Acting ◽

Asthmatic Children ◽

Beta Agonists ◽

Tertiary Center ◽

Long Acting

Abstract Asthma is one of the prevalent diseases in children. There is some evidence regarding benefits of camel milk in asthma. Present study was carried out evaluating the effect of camel milk in asthmatic children. A randomized double blind clinical trial was operated between 2018 and 2019 in a tertiary center. Sixty children aged more than 6 years with not well control asthma were included. Intervention was consist of 200 milliliter camel milk or placebo daily for 2 months. Spirometry parameters and medication regimen were assessed before and after intervention. Data was analyzed using SPSS software. A total of 57 patients completed the trial. Patients were similar in demographic and baseline characteristics (p > 0.05). There was a significant difference between groups after intervention in use of inhaled corticosteroids (96.7% versus 70.4%, p value = 0.01), short acting beta agonists (53.3% versus 29.6%, p value = 0.0001) and long acting beta agonists (53.3% versus 40.7%, p value = 0.04) in control and intervention respectively. The percent of changes in forced expiratory volume (FEV1) in control and intervention groups was 18.54 ± 14.89 and 21.89 ± 17.83 respectively (p = 0.14). The percent of changes in FEV1/forced vital capacity (FVC) in control and intervention groups was 8.11 ± 7.12 and 11.11 ± 8.33 respectively (p = 0.14). Conclusion: Camel milk leads to significant decrease in inhaled corticosteroids, short acting beta agonists and long acting beta agonist's use, surprisingly. It was suggested that camel milk is added to pharmacological treatment of asthmatic children after more studies.

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