Document 0535
 DOCN  M9590535
 TI    Bronchodilator pretreatment improves aerosol deposition uniformity in
       HIV-positive patients who cough while inhaling aerosolized pentamidine.
 DT    9509
 AU    Harrison KS; Laube BL; Division of Infectious Diseases, Johns Hopkins
       Medical; Institutions, Baltimore, USA.
 SO    Chest. 1994 Aug;106(2):421-6. Unique Identifier : AIDSLINE MED/95292658
 AB    OBJECTIVE: To determine the effect of bronchodilator pretreatment on
       deposition uniformity of aerosolized pentamidine (AP) in HIV-positive
       patients who coughed while inhaling AP. DESIGN: Nonrandomized control
       trial. SETTING: A university hospital. PATIENTS: Ten HIV-positive
       patients who were using AP prophylactically. INTERVENTION: Four patients
       who coughed during AP administration were pretreated with 10 mg
       metaproterenol aerosol prior to a second inhalation of AP. MEASUREMENTS:
       Skew, a measure of overall deposition symmetry, deposition in the apex
       vs the base of the right lung (A:B ratio), and percentage of change from
       baseline in peak expiratory flow rate (PEFR). RESULTS: At baseline, the
       average (+/- SD) skew value for four subjects who coughed (0.89 +/-
       0.19) was significantly higher than for six control subjects (0.58 +/-
       0.07) (p < 0.01), indicating enhanced nonuniformity of AP distribution.
       After bronchodilator, no one coughed and the average skew value was
       normalized to 0.57 +/- 0.13. The A:B ratios at baseline and after
       metaproterenol were not significantly different, suggesting that
       deposition of AP in the apex, relative to basal deposition, was not
       enhanced by bronchodilator treatment. When no bronchodilator was
       administered, average PEFR decreased to 330 +/- 162 from baseline (410
       +/- 84). Average PEFR increased to 429 +/- 85 from baseline (395 +/-
       116) after bronchodilator pretreatment. CONCLUSIONS: These results
       suggest that in addition to relieving cough in patients receiving AP
       prophylactically, pretreatment with metaproterenol enhances uniformity
       of distribution of AP and improves PEFR.
 DE    Adult  Aerosols  Cough/ETIOLOGY  Female  Gamma Cameras  Human  HIV
       Seropositivity/*DRUG THERAPY/PHYSIOPATHOLOGY/RADIONUCLIDE  IMAGING
       Lung/RADIONUCLIDE IMAGING  Male  Middle Age  Orciprenaline/*THERAPEUTIC
       USE  Peak Expiratory Flow Rate  Pentamidine/ADVERSE EFFECTS/*THERAPEUTIC
       USE  Support, U.S. Gov't, P.H.S.  Treatment Outcome  CLINICAL TRIAL
       CONTROLLED CLINICAL TRIAL  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).