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Efficacy and safety of eco-friendly inhalers: focus on combination ipratropium bromide and albuterol in chronic obstructive pulmonary disease.

Panos RJ - Int J Chron Obstruct Pulmon Dis (2013)

Bottom Line: The adverse environmental effects of CFC-pMDIs stimulated the invention of novel delivery systems including the Respimat SMI.CFC-pMDIs contributed to the depletion of the ozone layer and the surge in disorders caused by harmful ultraviolet B radiation.The Respimat SMI is an innovative device that produces a vapor of inhalable droplets with reduced velocity and prolonged aerosol duration that enhance deposition within the lower airway and is associated with improved patient satisfaction.

View Article: PubMed Central - PubMed

Affiliation: Pulmonary, Critical Care, and Sleep Medicine Division, Cincinnati Veterans Affairs Medical Center, Cincinnati, OH 45220, USA. ralph.panos@va.gov

ABSTRACT

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality and its treatment is critical to improve quality of life, reduce symptoms, and diminish the frequency of COPD exacerbations. Due to the harmful environmental effects of pressurized metered-dose inhalers (pMDIs) containing chlorofluorocarbons (CFCs), newer systems for delivering respiratory medications have been developed.

Methods: A search of the literature in the PubMed database was undertaken using the keywords "COPD," "albuterol," "ipratropium bromide," and "Respimat® Soft Mist Inhaler™"; pertinent references within the identified citations were included. The environmental effect of CFC-pMDIs, the invention of the Respimat® Soft Mist Inhaler™ (SMI) (Boehringer Ingelheim, Ingelheim, Germany), and its use to deliver the combination of albuterol and ipratropium bromide for the treatment of COPD were reviewed.

Results: The adverse environmental effects of CFC-pMDIs stimulated the invention of novel delivery systems including the Respimat SMI. This review presents its development, internal mechanism, and use to deliver the combination of albuterol and ipratropium bromide.

Conclusion: CFC-pMDIs contributed to the depletion of the ozone layer and the surge in disorders caused by harmful ultraviolet B radiation. The banning of CFCs spurred the development of novel delivery systems for respiratory medications. The Respimat SMI is an innovative device that produces a vapor of inhalable droplets with reduced velocity and prolonged aerosol duration that enhance deposition within the lower airway and is associated with improved patient satisfaction. Clinical trials have demonstrated that the Respimat SMI can achieve effects equivalent to pMDIs but with lower medication doses. The long-term safety and efficacy remain to be determined. The Respimat SMI delivery device is a novel, efficient, and well-received system for the delivery of aerosolized albuterol and ipratropium bromide to patients with COPD; however, the presence of longer-acting, less frequently dosed respiratory medications provide patients and providers with other therapeutic options.

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Related in: MedlinePlus

Maps of the hole in the Antarctic ozone layer demonstrating its enlargement over time.Note: Reproduced from Ozone hole through the years [web page on the Internet]. Greenbelt MD. Earth Observatory; 2011. Available from: http://earthobservatory.nasa.gov/IOTD/view.php?id=49040. Accessed Dec 2012.15
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f1-copd-8-221: Maps of the hole in the Antarctic ozone layer demonstrating its enlargement over time.Note: Reproduced from Ozone hole through the years [web page on the Internet]. Greenbelt MD. Earth Observatory; 2011. Available from: http://earthobservatory.nasa.gov/IOTD/view.php?id=49040. Accessed Dec 2012.15

Mentions: However, in 1971, Lovelock found traces of CFC-11 in the atmosphere.10 Studies of CFCs released into the environment showed that they rise from the troposphere (lower atmosphere) to the stratosphere (upper atmosphere). Due to strong bonds between carbon, chlorine, and fluorine, CFCs are resistant to degradation by environmental physical and biological systems and may remain in the stratosphere for over half a century.11,12 Contemporaneously, observational studies revealed an enlarging hole in the ozone layer above Antarctica (Figure 1).13,14 These seemingly disparate observations were linked in 1974 when Molina and Rowland16 theorized that chlorine radicals generated by the photolytic degradation of CFCs could cause the catalytic degradation of stratospheric ozone. Further investigations confirmed that CFCs are eventually degraded by solar radiation and release chlorine radicals that react with atmospheric ozone.17 One chlorine radical is estimated to eliminate up to 100,000 ozone molecules.18 Molina and Rowland received the 1995 Nobel Prize for attributing the shrinking ozone layer to the accumulation of CFCs in the stratosphere.


Efficacy and safety of eco-friendly inhalers: focus on combination ipratropium bromide and albuterol in chronic obstructive pulmonary disease.

Panos RJ - Int J Chron Obstruct Pulmon Dis (2013)

Maps of the hole in the Antarctic ozone layer demonstrating its enlargement over time.Note: Reproduced from Ozone hole through the years [web page on the Internet]. Greenbelt MD. Earth Observatory; 2011. Available from: http://earthobservatory.nasa.gov/IOTD/view.php?id=49040. Accessed Dec 2012.15
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3643287&req=5

f1-copd-8-221: Maps of the hole in the Antarctic ozone layer demonstrating its enlargement over time.Note: Reproduced from Ozone hole through the years [web page on the Internet]. Greenbelt MD. Earth Observatory; 2011. Available from: http://earthobservatory.nasa.gov/IOTD/view.php?id=49040. Accessed Dec 2012.15
Mentions: However, in 1971, Lovelock found traces of CFC-11 in the atmosphere.10 Studies of CFCs released into the environment showed that they rise from the troposphere (lower atmosphere) to the stratosphere (upper atmosphere). Due to strong bonds between carbon, chlorine, and fluorine, CFCs are resistant to degradation by environmental physical and biological systems and may remain in the stratosphere for over half a century.11,12 Contemporaneously, observational studies revealed an enlarging hole in the ozone layer above Antarctica (Figure 1).13,14 These seemingly disparate observations were linked in 1974 when Molina and Rowland16 theorized that chlorine radicals generated by the photolytic degradation of CFCs could cause the catalytic degradation of stratospheric ozone. Further investigations confirmed that CFCs are eventually degraded by solar radiation and release chlorine radicals that react with atmospheric ozone.17 One chlorine radical is estimated to eliminate up to 100,000 ozone molecules.18 Molina and Rowland received the 1995 Nobel Prize for attributing the shrinking ozone layer to the accumulation of CFCs in the stratosphere.

Bottom Line: The adverse environmental effects of CFC-pMDIs stimulated the invention of novel delivery systems including the Respimat SMI.CFC-pMDIs contributed to the depletion of the ozone layer and the surge in disorders caused by harmful ultraviolet B radiation.The Respimat SMI is an innovative device that produces a vapor of inhalable droplets with reduced velocity and prolonged aerosol duration that enhance deposition within the lower airway and is associated with improved patient satisfaction.

View Article: PubMed Central - PubMed

Affiliation: Pulmonary, Critical Care, and Sleep Medicine Division, Cincinnati Veterans Affairs Medical Center, Cincinnati, OH 45220, USA. ralph.panos@va.gov

ABSTRACT

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality and its treatment is critical to improve quality of life, reduce symptoms, and diminish the frequency of COPD exacerbations. Due to the harmful environmental effects of pressurized metered-dose inhalers (pMDIs) containing chlorofluorocarbons (CFCs), newer systems for delivering respiratory medications have been developed.

Methods: A search of the literature in the PubMed database was undertaken using the keywords "COPD," "albuterol," "ipratropium bromide," and "Respimat® Soft Mist Inhaler™"; pertinent references within the identified citations were included. The environmental effect of CFC-pMDIs, the invention of the Respimat® Soft Mist Inhaler™ (SMI) (Boehringer Ingelheim, Ingelheim, Germany), and its use to deliver the combination of albuterol and ipratropium bromide for the treatment of COPD were reviewed.

Results: The adverse environmental effects of CFC-pMDIs stimulated the invention of novel delivery systems including the Respimat SMI. This review presents its development, internal mechanism, and use to deliver the combination of albuterol and ipratropium bromide.

Conclusion: CFC-pMDIs contributed to the depletion of the ozone layer and the surge in disorders caused by harmful ultraviolet B radiation. The banning of CFCs spurred the development of novel delivery systems for respiratory medications. The Respimat SMI is an innovative device that produces a vapor of inhalable droplets with reduced velocity and prolonged aerosol duration that enhance deposition within the lower airway and is associated with improved patient satisfaction. Clinical trials have demonstrated that the Respimat SMI can achieve effects equivalent to pMDIs but with lower medication doses. The long-term safety and efficacy remain to be determined. The Respimat SMI delivery device is a novel, efficient, and well-received system for the delivery of aerosolized albuterol and ipratropium bromide to patients with COPD; however, the presence of longer-acting, less frequently dosed respiratory medications provide patients and providers with other therapeutic options.

Show MeSH
Related in: MedlinePlus