Bronchoconstrictor additives in bronchodilator solutions

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Presentation transcript:

Bronchoconstrictor additives in bronchodilator solutions Michael J. Asmus, PharmD, James Sherman, MD, Leslie Hendeles, PharmD Journal of Allergy and Clinical Immunology Volume 104, Issue 2, Pages S53-S60 (August 1999) DOI: 10.1016/S0091-6749(99)70274-5 Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 1 Bronchoconstrictor additive content of commercially available albuterol products for nebulization (left to right) . The nonsterile unit-dose screwcap vial (manufactured by Schering-Plough/Warrick) contains 300 μg of BAC per 2.5 mg dose of albuterol. The nonsterile multidose dropper bottle (manufactured by Schering-Plough, Glaxo-Welcome, Bausch and Lomb, Copley, and Hi Tech Pharmaceuticals) contains 50 μg of BAC in each 2.5 mg dose of albuterol. The sterile unit-dose vial (manufactured by Dey Laboratories) contains 300 μg of EDTA per 2.5 mg dose of albuterol. Other sterile unit-dose vials (manufactured by Alpharma, Glaxo-Welcome, and Nephron) contain no additives in each 2.5 mg dose of albuterol. Journal of Allergy and Clinical Immunology 1999 104, S53-S60DOI: (10.1016/S0091-6749(99)70274-5) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 2 Dose-response to inhaled challenge with benzalkonium chloride in 28 subjects with asthma. Percentage fall from baseline in FEV1 appears on the ordinate. The cumulative dose of BAC in micromoles appears on the abscissa. One micromole is equivalent to 354 μg of BAC. All but 3 subjects had at least a 10% drop in FEV1 during BAC challenge; 17 of the 28 subjects had a greater than 20% decrease in FEV1 . (From Zhang YG, Wright WJ, Tarn WK, Nguyen-Dang TH, Salome CM, Woolcock AJ. Effects of inhaled preservatives on asthmatic subjects. II. Benzalkonium Chloride. Am Rev Respir Dis 1990;141:1405-8. Official journal of the American Thoracic Society. © American Lung Association.) Journal of Allergy and Clinical Immunology 1999 104, S53-S60DOI: (10.1016/S0091-6749(99)70274-5) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 3 Comparison of the provocational concentration of BAC or EDTA required to induce a 20% decrease from baseline in FEV1 (PC20 FEV1 ) in 22 subjects with stable asthma. PC20 FEV1 values (in mg/mL) appear on the ordinate. Bronchoprovocational agent (BAC or EDTA) appears on the abscissa. Thick horizontal lines represent mean PC20 FEV1 values for each agent. Gray bars represent the range of PC20 FEV1 values for each agent. The ranges are also listed in parenthesis below the agent on the abscissa. (Data from Beasley CRW, Rafferty P, Holgate ST. Bronchoconstrictor properties of preservatives in ipratropium bromide (Atrovent) nebulizer solution. Br Med J 1987;294:1197-8.) Journal of Allergy and Clinical Immunology 1999 104, S53-S60DOI: (10.1016/S0091-6749(99)70274-5) Copyright © 1999 Mosby, Inc. Terms and Conditions