Use of Meter Dose Inhaler (MDI) Corticosteroid Therapy, May Cause Tuberculosis, in Patients with Bronchial Asthma

This article refutes one popular-science review that has appeared on the MDedge news site in January 2020. It has stated that there was no effect of vaccination with 7-valent pneumococcal conjugate vaccine (PCV-7) against invasive forms of Streptococcus pneumoniae in children with bronchial asthma. The author of this publication refers to the article «Asthma and the Risk of Invasive Pneumococcal Disease: A Meta-analysis» that described episodes of invasive pneumococcal disease and pneumonia development in children with bronchial asthma and in healthy children who was vaccinated with pneumococcal conjugate vaccine. It was concluded that the PCV-7 provides limited protection against colonization only with vaccine pneumococcus serotypes (according to the obtained data), and, thus, there was high risk of carriage of non-included serotypes in children with bronchial asthma (BA). The analysis of the article mentioned above has revealed that the representativeness of the data is extremely low. For example, the study groups were selected incorrectly, the PCV-7 administration scheme was not analyzed, whereas its violation may cause ineffective immunity development and as result disease development. Another crucial aspect is the lack of any data on the BA severity and inhaled corticosteroid therapy in vaccinated children. Nowadays, there are numerous scientific studies on the clinical efficacy of PCV in the prevention of IPD including the children with BA. Most world-class experts support the necessity of PCV-7 usage in children with BA for the prevention of IPD and suggest their patients over 6 years old on inhaled corticosteroid therapy to perform additional administration of pneumococcal polysaccharide vaccine.

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An Investigation of the Use of a Metered-Dose Inhaler(MDI) in Patients with Bronchial Asthma and the Pharmaceutical Instructions.

Japanese Journal of Hospital Pharmacy ◽

10.5649/jjphcs1975.25.65 ◽

1999 ◽

Vol 25 (1) ◽

pp. 65-68

Author(s):

YOSHIKO YAHATA ◽

NORIKO YOKOZAWA ◽

AIKO OSAWA ◽

TOMOHIRO KAWADA ◽

YOSHITAKA KURASAWA ◽

...

Keyword(s):

Bronchial Asthma ◽

Dose Inhaler ◽

Metered Dose Inhaler ◽

Metered Dose

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STUDY OF EFFICACY OF METERED DOSE INHALER (MDI) AND DRY POWDER INHALER (DPI) FOR DELIVERY OF SALBUTAMOL IN TREATMENT OF ACUTE EXACERBATION OF ASTHMA IN PATIENTS, ATTENDING IN TERTIARY CARE HOSPITAL AT, PATNA

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i3.1078 ◽

2020 ◽

Vol 4 (3) ◽

Author(s):

Ajit Kumar ◽

Raj Narayan Seth

Keyword(s):

Acute Exacerbation ◽

Bronchial Asthma ◽

Tertiary Care ◽

Dry Powder Inhaler ◽

Dose Inhaler ◽

Care Hospital ◽

Metered Dose Inhaler ◽

Dry Powder ◽

Accessory Muscle ◽

Metered Dose

Objective: Present study was undertaken to compare the efficacy of Metered dose inhaler (MDI) with spacer and with Dry powder inhaler (DPI) for delivery of salbutamol in acute exacerbation of bronchial asthma. It is a randomized controlled trial study. Material and Methods: A total of 78 children in the age group of 6-14 years who presented with a mild or moderate acute exacerbation of asthma were included in the study. Salbutamol dose of 400µg were given to all the children’s by either a MDI with spacer or a DPI in randomized pattern. All the changes in the wheezing and accessory muscle scores, Sa02, and PEFR were noted. Results: Out of 78 children, 42 were assigned to the MDI spacer group and 36 to rotahaler (DPI) group. After receiving treatment, the PEFR improved by about 14% in both the groups. The oxygen saturation increased by 2.1% in both the groups. Within each group, the improvement in PEFR, Sa02, wheeze and accessory muscle score after the treatment was statistically significant. Conclusion: Metered dose inhaler with spacer and Dry powder inhaler are equally effective in delivering salbutamol in therapy of mild to moderate acute exacerbations of bronchial asthma in children between 6-14 years of age Keyword: DPI, Salbutamol, Treatment, Asthma, Children, MDI, PEFR

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IgE LEVELS IN SERA OF CHILDREN WITH ASTHMA

PEDIATRICS ◽

10.1542/peds.47.5.848 ◽

1971 ◽

Vol 47 (5) ◽

pp. 848-856

Author(s):

Lata Kumar ◽

Richard W. Newcomb ◽

Kimishige Ishizaka ◽

Elliott Middleton ◽

Margaret M. Hornbrook

Keyword(s):

Atopic Dermatitis ◽

Bronchial Asthma ◽

Corticosteroid Therapy ◽

Systemic Corticosteroid ◽

Skin Tests ◽

Positive Skin ◽

Children With Asthma ◽

Severity Of The Disease ◽

Systemic Corticosteroid Therapy

Concentrations of the immunoglobulin that is associated with reaginic activity, IgE (γE), were measured in sera of 116 children with bronchial asthma. High γE (>700 ng/ml) were found in only 30. High γE levels were found in children with many positive skin tests (P < 0.01) and with active atopic dermatitis (P < 0.01). Long term, systemic corticosteroid therapy was found to be associated with normal γE values (P < .001) even when the characteristics of the disease would otherwise have indicated high values. As no correlation is found to be evident between severity of the disease and γE levels, it may be suggested that corticosteroids may decrease intravascular γE. The serum γE values failed to reveal two or more clinically different groups among our patients.

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Serum Eosinophil Cationic Protein Is a Useful Marker for Assessing the Efficacy of Inhaled Corticosteroid Therapy in Children with Bronchial Asthma

The Tohoku Journal of Experimental Medicine ◽

10.1620/tjem.242.263 ◽

2017 ◽

Vol 242 (4) ◽

pp. 263-271 ◽

Cited By ~ 2

Author(s):

Cai-Li Guo ◽

Xiao-Min Sun ◽

Xiao-Wen Wang ◽

Qing Guo

Keyword(s):

Bronchial Asthma ◽

Corticosteroid Therapy ◽

Eosinophil Cationic Protein ◽

Inhaled Corticosteroid ◽

Cationic Protein

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Two Fatal Cases of Hepatitis B Virus Carriers after Corticosteroid Therapy for Bronchial Asthma.

Internal Medicine ◽

10.2169/internalmedicine.31.208 ◽

1992 ◽

Vol 31 (2) ◽

pp. 208-213 ◽

Cited By ~ 10

Author(s):

Yuriko KOGA ◽

Ryukichi KUMASHIRO ◽

Kiyoshi YASUMOTO ◽

Satoshi SHAKADO ◽

Noriyuki ONO ◽

...

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Bronchial Asthma ◽

Corticosteroid Therapy ◽

B Virus

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Critical Inhaler Administration Errors of Patients on Pressurized Meter Dose Inhaler (pMDI): A Hospital-Based Cross-Sectional Study in Malaysia

Hospital Pharmacy ◽

10.1177/00185787211010164 ◽

2021 ◽

pp. 001857872110101

Author(s):

Retha Rajah ◽

Yi Woei Tang ◽

Shien Chee Ho ◽

Jo Lyn Tan ◽

Muhamad Shuhaimi Mat Said ◽

...

Keyword(s):

Knowledge Score ◽

Cross Sectional Study ◽

Education Level ◽

Dose Inhaler ◽

Meter Dose Inhaler ◽

Cross Sectional ◽

Copd Patients ◽

Number Of Patients ◽

Metered Dose ◽

Inhaled Medication

Background: Inhaler technique errors can affect the disease outcome through reduced deposition of medication in the lungs with certain errors were more likely to deter the optimum drug from reaching the lung. The objective of this study was to evaluate the pressurized metered-dose inhaler (pMDI) critical technique errors among asthma and COPD patients, and to investigate the predictors of those errors. Methods: A cross-sectional, observational, and multi-centered study conducted in 3 major hospitals in the state of Penang, Malaysia. Asthma and COPD patients aged 18 years or older consented to the study were consecutively recruited if they were at least on 1 pMDI without mouthpiece spacer or facemask space. Direct observation of the patient’s technique was recorded using a standard checklist and certain steps in the checklist were pre-determined as critical steps. The number of patients missed or incorrectly performed the steps including the critical steps were documented. Using logistic regression, the factors associated with the critical errors were determined, and the correlation was evaluated between age and pMDI knowledge score with critical inhalation steps score. Results: Of 209 patients observed, only less than half (40.7%) could perform all the critical pMDI steps correctly. Low education level was the only factor associated with critical inhaler errors. The increased knowledge of their inhaled medication was found to positively correlate with the correct critical inhalation steps. The critical errors also increase with the increased age of patients. Conclusion: The majority of the study population make inhalation error particularly in critical steps. Training and education intervention programs may help patients with lower education level, as well as those of advanced age and lack of knowledge of their inhaled medication because those populations are at a greater risk of committing critical errors in their use of pMDI.

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