02Mar 2018

COMPARISON OF FORMOTEROL-BUDESONIDE FORMULATION NEBULIZED ALONE AND IN COMBINATION WITH IPRATROPIUM BROMIDE FORMULATION IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE.

  • Department of Pharmacology, SGT Medical College, Hospital and Research Institute, Gurugram, Haryana.
  • Department of Pulmonary Medicine, SGT Medical College, Hospital and Research Institute, Gurugram, Haryana.
  • Department of Pharmacology, Shaheed Hasan Khan Mewati Government Medical College, Nalhar, Mewat, Haryana.
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Background: Chronic Obstructive Pulmonary Disease (COPD) is a clinical syndrome associated with gradually progressive narrowing of the airways due to inflammation. The syndrome includes Bronchitis, Emphysema and small airway disease with common symptoms due to inflammation and chronic airflow obstruction. Methods: COPD patients aged 40 years or more were allocated in two treatment groups. Group 1 was nebulized with Formoterol- Budesonide formulation (double drug) and Group 2 with Formoterol-Budesonide formulation along with Ipratropium bromide formulation (triple drug). Spirometry parameters were recorded at baseline and thirty minutes after nebulization. Results: Within half an hour after nebulization, there was a statistically significant increase in all the Spirometry parameters in both the groups. The increase was slightly more in triple drug group (n=26).The mean difference in the pre & post-nebulization parameters was taken and it was found that only PEFR had statistically significant increase post-nebulization. All Spirometry parameters increase was similar in both the groups. Conclusions: The results of triple drug combination were slightly better (group 2). Mean change in the nebulization parameters showed statistically significant increase in PEFR in group 2.

  1. John J. Reilly, Edwin K. Silverman, Steven D. Shapiro. Chronic Obstructive Pulmonary Disease. In: Anthony S. Fauci, Eugene Braunwald, Dennis L Kasper, Stephen L Hauser, Dan L. Longo, J. Larry Jameson et al. Harrison?s Principles of Internal Medicine.? 17th New York, NY: Mc Graw-Hill; 2008:1635-42.
  2. Philip T Diaz and Daren L Knoell. Chronic Obstructive Pulmonary Disease. In: Kimble Mary Anne Koda, Young Lloyd Yee, Alldredge Brian K, Corelli Robin L, Guglielmo B Joseph, Kradjan Wayne A et al. Applied Therapeutics, The clinical use of drugs. 9th? Wolter Kluwer health. 2009; 23:? 1-19.
  3. P Ravi Kumar, G Priyadarshini Bai, H.V. Suryanarayana. Study of Electrolyte Disturbances in Acute Asthma.? Int J Biol Med Res. 2013; 4(3): 3479 ? 82.
  4. Rabe KF, Atienza T, Magyar P, Larsson P, Jorup C, Lalloo UG. Effect of budesonide in combination with formoterol for reliever therapy in asthma exacerbations:? a randomised controlled, double-blind study.? Lancet 2006; 368(9537):744-53.
  5. Peter J.Barnes. Pulmonary Pharmcology. In: Laurence L Brunton, Bruce A Chabner, Bjorn C Knollman. Goodman & Gillman?s The Pharmacological basis of therapeutics. 12th New York, NY: McGraw-Hill; 2010; 1035 -43.
  6. Tashkin P Donald. A review of nebulized drug delivery in COPD.? Int J COPD 2016; 11:? 2585-96.
  7. Brusselle G, Price DB, Gruffydd-Jones K, Miravitlles M, Keininger D, Stewart R et al. The inevitable drift to triple therapy in COPD:? an analysis of prescribing pathways in the UK.? Int J Chron Obstruct Pulmon Dis 2015; 10:? 2207-17.
  8. Welte T, Miravitlles M, Hernandez P, Eriksson G, Peterson S, Polanowski T et al. Efficacy and tolerability of budesonide/formoterol added to Tiotropium in patients with chronic obstructive pulmonary disease.? Am J Respir Crit Care Med 2009; 180(8):? 741-50.
  9. Singh D, Brooks J, Hagan G, Cahn A, O?Connor BJ. Superiority of ?triple? therapy with Salmeterol/fluticasone propionate and Tiotropium bromide versus individual components in moderate to severe COPD.? Thorax 2008; 63(7):? 592-8.
  10. Jung KS, Park HY, Park SY, Kim SK, Kim YK, Shim JJ et al. Comparison of Tiotropium plus fluticasone propionate/Salmeterol with Tiotropium in COPD:? a randomized controlled study.? Respir Med 2012; 106(3):? 382-9.
  11. Hanania NA, Crater GD, Morris AN, Emmett AH, O?Dell DM, Niewoehner DE.? Benefits of adding fluticasone propionate/Salmeterol to Tiotropium in moderate to severe COPD.? Respir Med 2012; 106(1):? 91-101.
  12. Frith PA, Thompson PJ, Ratnavadivel R, Chang CL, Bremner P, Day P et al.? Glycopyrronium once-daily significantly improves lung function and health status when combined with Salmeterol/fluticasone in patients with COPD:? the GLISTEN study, a randomized controlled trial.? Thorax 2015; 70(6):? 519-27.
  13. Siler TM, Kervin E, Singletary K, Brooks J, Church A. Efficacy and safety of Umeclidinium added to fluticasone propionate/Salmeterol in patients with COPD:? Results of two randomized, double blind studies.? COPD 2016; 13(1):? 1-10.
  14. Singh D, Papi A, Corradi M, Pavlisova L, Montagna L, Francisco C et al. Single inhaler triple therapy versus inhaled corticosteroid plus long-acting beta2-agonist therapy for chronic obstructive pulmonary disease (TRILOGY):? a double-blind, parallel group, randomized controlled trial.? Lancet 2016; 388(10048):? 963-73.
  15. Aaron SD, Vandemheen KL, Fergusson D, Francols Maltals, Jean Bourbeau, Roger Goldstein et al. Tiotropium in combination with placebo, Salmeterol or fluticasone-salmeterol for treatment of chronic obstructive pulmonary disease:? a randomized trial.? Ann Intern Med 2007; 146(8):? 544-55.
  16. Tashkin P Donald. A review of nebulized drug delivery in COPD.? Int J COPD 2016; 11:? 2585-96.
  17. Kikis D, Esser H, Heinrich K. Influence of Ipratropium bromide on Heart rate and Hemodynamics in patients with sinus bradycardia. Clin Cardiol 1982; 5(8):? 441-5.

[Juhi Singla, S C Chopra, D P S Sudan, Shweta Sharma, Naveen Kumar and Vinod Kapoor. (2018); COMPARISON OF FORMOTEROL-BUDESONIDE FORMULATION NEBULIZED ALONE AND IN COMBINATION WITH IPRATROPIUM BROMIDE FORMULATION IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE. Int. J. of Adv. Res. 6 (Mar). 131-136] (ISSN 2320-5407). www.journalijar.com

Dr Juhi Singla
Post Graduate Student

DOI:

Article DOI: 10.21474/IJAR01/6658      
DOI URL: http://dx.doi.org/10.21474/IJAR01/6658

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