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  1. Book ; Online ; E-Book: Inhaled delivery systems for the treatment of asthma and COPD

    Mahler, Donald A. / Dhand, Rajiv

    2023  

    Author's details edited by Donald A. Mahler, Rajiv Dhand
    Keywords Asthma / drug therapy ; Pulmonary Disease, Chronic Obstructive / drug therapy ; Administration, Inhalation ; Respiratory Therapy / methods ; Nebulizers and Vaporizers ; Aerosols ; Asthma/Treatment ; Lungs/Diseases, Obstructive/Treatment ; Respiratory therapy/Equipment and supplies
    Subject code 616.238061
    Language English
    Size 1 Online-Ressource (xiv, 194 Seiten), Illustrationen
    Publisher CRC Press
    Publishing place Boca Raton
    Publishing country United States
    Document type Book ; Online ; E-Book
    Remark Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
    HBZ-ID HT030061548
    ISBN 9781000884425 ; 9781032215747 ; 1000884422 ; 1032215747
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  2. Article ; Online: Inhaled Tobramycin for Treatment of Ventilator-Associated Pneumonia: The Interplay of Patient, Drug, and Device.

    Dhand, Rajiv

    Respiratory care

    2023  Volume 67, Issue 1, Page(s) 151–153

    MeSH term(s) Humans ; Tobramycin/therapeutic use ; Pneumonia, Ventilator-Associated/drug therapy ; Anti-Bacterial Agents/therapeutic use ; Administration, Inhalation ; Patients ; Pseudomonas Infections/drug therapy
    Chemical Substances Tobramycin (VZ8RRZ51VK) ; Anti-Bacterial Agents
    Language English
    Publishing date 2023-04-17
    Publishing country United States
    Document type Editorial
    ZDB-ID 603252-7
    ISSN 1943-3654 ; 0098-9142 ; 0020-1324
    ISSN (online) 1943-3654
    ISSN 0098-9142 ; 0020-1324
    DOI 10.4187/respcare.09852
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Mitigating Viral Dispersion during Respiratory Support Procedures in the ICU.

    Dhand, Rajiv

    American journal of respiratory and critical care medicine

    2021  Volume 203, Issue 9, Page(s) 1051–1053

    MeSH term(s) Critical Care ; Humans ; Intensive Care Units
    Language English
    Publishing date 2021-02-22
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202102-0317ED
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Reproducible Dosing With a Jet Nebulizer During Invasive Mechanical Ventilation.

    Dhand, Rajiv

    Respiratory care

    2020  Volume 65, Issue 8, Page(s) 1223–1224

    MeSH term(s) Administration, Inhalation ; Aerosols ; Albuterol ; Humans ; Nebulizers and Vaporizers ; Respiration, Artificial
    Chemical Substances Aerosols ; Albuterol (QF8SVZ843E)
    Language English
    Publishing date 2020-07-23
    Publishing country United States
    Document type Editorial
    ZDB-ID 603252-7
    ISSN 1943-3654 ; 0098-9142 ; 0020-1324
    ISSN (online) 1943-3654
    ISSN 0098-9142 ; 0020-1324
    DOI 10.4187/respcare.08279
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: The 2023 GOLD Report: Updated Guidelines for Inhaled Pharmacological Therapy in Patients with Stable COPD.

    Terry, Paul D / Dhand, Rajiv

    Pulmonary therapy

    2023  Volume 9, Issue 3, Page(s) 345–357

    Abstract: Over the past 22 years, annual GOLD Reports have documented important changes in guidance and recommendations for uniformly treating patients with chronic obstructive pulmonary disease (COPD) with the goal of improving outcomes in patients suffering from ...

    Abstract Over the past 22 years, annual GOLD Reports have documented important changes in guidance and recommendations for uniformly treating patients with chronic obstructive pulmonary disease (COPD) with the goal of improving outcomes in patients suffering from this condition. The most recent GOLD Report, released in 2023, shows continued refinement in several areas, including more precise definitions of COPD and exacerbations of COPD, a new set of parameters to assess exacerbation severity, an updated COPD assessment tool, updated guidelines for initial and follow-up treatment, new information regarding the association between pharmacological triple therapy and reduction in mortality, and new discussions of inhaler device choice and adherence to COPD medications. Whereas we do not address all of the new or updated material in GOLD's 2023 Report, we summarize key changes in GOLD's recommendations regarding inhalation therapy for stable COPD and frame these changes in the context of previous GOLD recommendations.
    Language English
    Publishing date 2023-07-20
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2364-1746
    ISSN (online) 2364-1746
    DOI 10.1007/s41030-023-00233-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Correction to: Inhalation Therapy for Stable COPD: 20 Years of GOLD Reports.

    Terry, Paul D / Dhand, Rajiv

    Advances in therapy

    2021  Volume 38, Issue 9, Page(s) 4986–4988

    Language English
    Publishing date 2021-07-24
    Publishing country United States
    Document type Published Erratum
    ZDB-ID 632651-1
    ISSN 1865-8652 ; 0741-238X
    ISSN (online) 1865-8652
    ISSN 0741-238X
    DOI 10.1007/s12325-021-01857-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: The association of preexisting severe asthma with COVID-19 outcomes.

    Terry, Paul D / Heidel, R Eric / Dhand, Rajiv

    Current opinion in pulmonary medicine

    2023  Volume 29, Issue 3, Page(s) 215–222

    Abstract: Purpose of review: Three years after the emergence of coronavirus disease 2019 (COVID-19), many studies have examined the association between asthma and COVID-related morbidity and mortality, with most showing that asthma does not increase risk. However, ...

    Abstract Purpose of review: Three years after the emergence of coronavirus disease 2019 (COVID-19), many studies have examined the association between asthma and COVID-related morbidity and mortality, with most showing that asthma does not increase risk. However, the U.S. Centers for Disease Control (CDC) currently suggests that patients with severe asthma may, nonetheless, be particularly vulnerable to COVID-19-related morbidity.
    Recent findings: With respect to poor COVID-19 outcomes, our search yielded nine studies that quantified associations with severe asthma, seven that considered use of monoclonal antibodies (mAB), and 14 that considered inhaled corticosteroids (ICS) use. mAb and ICS use have been used as measures of severe asthma in several studies. Severe asthma was significantly associated with poor COVID-19 outcomes. The results for mAb and ICS were mixed.
    Summary: An increased risk of poor COVID-19 outcomes in patients with severe asthma is possible. However, these studies remain sparse and suffer from several methodological limitations that hinder their interpretation. Additional evidence is needed to provide clear, cogent guidance for health agencies seeking to inform patients with asthma about potential risks due to COVID-19.
    MeSH term(s) Humans ; Administration, Inhalation ; Anti-Asthmatic Agents/therapeutic use ; Asthma/complications ; Asthma/drug therapy ; Asthma/epidemiology ; COVID-19/complications ; COVID-19/epidemiology ; Glucocorticoids/administration & dosage ; Glucocorticoids/therapeutic use ; Antibodies, Monoclonal/therapeutic use ; Patient Acuity ; Risk Factors ; Outcome Assessment, Health Care
    Chemical Substances Anti-Asthmatic Agents ; Glucocorticoids ; Antibodies, Monoclonal
    Language English
    Publishing date 2023-03-17
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 1285505-4
    ISSN 1531-6971 ; 1070-5287 ; 1078-1641
    ISSN (online) 1531-6971
    ISSN 1070-5287 ; 1078-1641
    DOI 10.1097/MCP.0000000000000954
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Inhaled Drug Therapy 2016: The Year in Review.

    Dhand, Rajiv

    Respiratory care

    2017  Volume 62, Issue 7, Page(s) 978–996

    Abstract: Some recent salient publications related to inhaled drug therapy are discussed. Unexpectedly, a 2.5-μg once-daily dose of tiotropium (Respimat) had greater efficacy than the 5.0-μg daily dose. Occurrence of a reverse dose response serves to caution us ... ...

    Abstract Some recent salient publications related to inhaled drug therapy are discussed. Unexpectedly, a 2.5-μg once-daily dose of tiotropium (Respimat) had greater efficacy than the 5.0-μg daily dose. Occurrence of a reverse dose response serves to caution us that administering more drug is not always beneficial. Small-airway inflammation contributes to pathogenesis of asthma, especially severe asthma. However, there is no conclusive evidence that the use of small-particle aerosols to target small airways improves clinical outcomes in controlled clinical trials. Clinical outcomes of patients with symptomatic asthma have been better in "real-life" studies when fine-particle aerosols were compared with conventional (large-particle) aerosols. In subjects with COPD, the FLAME study indicates that a long-acting antimuscarinic agent/long-acting β-agonist combination was superior to an inhaled corticosteroid/long-acting β-agonist combination in preventing exacerbations. Another study in children with asthma and adults with asthma or COPD showed that peak inhalation flow must be considered in the context of the dry powder inhaler resistance. Investigators from the United Kingdom have shown modest success in replacing the defective cystic fibrosis transmembrane regulator gene in subjects with cystic fibrosis with a plasmid encoding the normal cystic fibrosis transmembrane regulator gene packaged within a non-viral vector. Also, inhaled antibiotics in patients with non-cystic fibrosis bronchiectasis and inhaled interferon-γ in patients with idiopathic pulmonary fibrosis have shown encouraging results but are investigational at this time. Compared to combustion cigarettes, use of e-cigarettes reduces exposure to carcinogens and volatile organic compounds. However, high levels of benzaldehyde in the vapor from cherry-flavored cigarettes raise concerns about the safety of some food flavorings in e-cigarettes.
    Language English
    Publishing date 2017-07
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 603252-7
    ISSN 1943-3654 ; 0098-9142 ; 0020-1324
    ISSN (online) 1943-3654
    ISSN 0098-9142 ; 0020-1324
    DOI 10.4187/respcare.05624
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: How Should Aerosols Be Delivered During Invasive Mechanical Ventilation?

    Dhand, Rajiv

    Respiratory care

    2017  Volume 62, Issue 10, Page(s) 1343–1367

    Abstract: The delivery of aerosols to mechanically ventilated patients presents unique challenges and differs from inhaled drug delivery in spontaneously breathing patients in several respects. Successful aerosol delivery during invasive mechanical ventilation ... ...

    Abstract The delivery of aerosols to mechanically ventilated patients presents unique challenges and differs from inhaled drug delivery in spontaneously breathing patients in several respects. Successful aerosol delivery during invasive mechanical ventilation requires careful consideration of a host of factors that influence the amount of drug inhaled by the patient. Pressurized metered-dose inhalers and nebulizers (jet, ultrasonic, and vibrating mesh) are the most commonly used aerosol delivery devices in these patients, although other delivery devices, such as dry powder inhalers, soft mist inhalers, and intratracheal nebulizing catheters, could also be adapted for in-line use. Bronchodilators, inhaled corticosteroids, antibiotics, pulmonary surfactant, mucolytics, biologicals, genes, prostanoids, and other agents are administered by inhalation during mechanical ventilation for a variety of indications. The goals of inhalation therapy during mechanical ventilation could be best achieved by (1) assuring drug delivery; (2) optimizing drug deposition in the lung; (3) providing consistent dosing; (4) avoiding inappropriate therapies; (5) achieving reproducible dosing; (6) employing clinically feasible methods; (7) enhancing the safety of inhaled drugs; and (8) controlling costs of aerosol therapy. The techniques of administration of aerosols with various delivery devices during mechanical ventilation are well known, but there continues to be significant variation in clinical practice and guidelines are needed to provide best practices for a wide range of clinical settings encountered in mechanically ventilated patients.
    Keywords covid19
    Language English
    Publishing date 2017-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603252-7
    ISSN 1943-3654 ; 0098-9142 ; 0020-1324
    ISSN (online) 1943-3654
    ISSN 0098-9142 ; 0020-1324
    DOI 10.4187/respcare.05803
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: The Rationale and Evidence for Use of Inhaled Antibiotics to Control Pseudomonas aeruginosa Infection in Non-cystic Fibrosis Bronchiectasis.

    Dhand, Rajiv

    Journal of aerosol medicine and pulmonary drug delivery

    2017  Volume 31, Issue 3, Page(s) 121–138

    Abstract: Non-cystic fibrosis bronchiectasis (NCFBE) is a chronic inflammatory lung disease characterized by irreversible dilation of the bronchi, symptoms of persistent cough and expectoration, and recurrent infective exacerbations. The prevalence of NCFBE is on ... ...

    Abstract Non-cystic fibrosis bronchiectasis (NCFBE) is a chronic inflammatory lung disease characterized by irreversible dilation of the bronchi, symptoms of persistent cough and expectoration, and recurrent infective exacerbations. The prevalence of NCFBE is on the increase in the United States and Europe, but no licensed therapies are currently available for its treatment. Although there are many similarities between NCFBE and cystic fibrosis (CF) in terms of respiratory symptoms, airway microbiology, and disease progression, there are key differences, for example, in response to treatment, suggesting differences in pathogenesis. This review discusses possible reasons underlying differences in response to inhaled antibiotics in people with CF and NCFBE. Pseudomonas aeruginosa infections are associated with the most severe forms of bronchiectasis. Suboptimal levels of antibiotics in the lung increase the mutation frequency of P. aeruginosa and lead to the development of mucoid strains characterized by formation of a protective polysaccharide biofilm. Mucoid strains of P. aeruginosa are associated with a chronic infection stage, requiring long-term antibiotic therapy. Inhaled antibiotics provide targeted delivery to the lung with minimal systemic toxicity and adverse events compared with oral/intravenous routes of administration, and they could be alternative treatment options to help address some of the treatment challenges in the management of severe cases of NCFBE. This review provides an overview of completed and ongoing trials that evaluated inhaled antibiotic therapy for NCFBE. Recently, several investigators conducted phase 3 randomized controlled trials with inhaled aztreonam and ciprofloxacin in patients with NCFBE. While the aztreonam trial results were not associated with significant clinical benefit in NCFBE, initial results reported from the inhaled ciprofloxacin (dry powder for inhalation and liposome-encapsulated/dual-release formulations) trials hold promise. A more targeted approach could identify specific populations of NCFBE patients who benefit from inhaled antibiotics.
    MeSH term(s) Administration, Inhalation ; Anti-Bacterial Agents/administration & dosage ; Anti-Bacterial Agents/adverse effects ; Bronchiectasis/drug therapy ; Clinical Trials, Phase III as Topic ; Drug Resistance, Bacterial ; Female ; Humans ; Male ; Middle Aged ; Pseudomonas Infections/drug therapy ; Pseudomonas aeruginosa ; Randomized Controlled Trials as Topic
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2017-10-27
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2417924-3
    ISSN 1941-2703 ; 1941-2711
    ISSN (online) 1941-2703
    ISSN 1941-2711
    DOI 10.1089/jamp.2017.1415
    Database MEDical Literature Analysis and Retrieval System OnLINE

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