Ipratropium Bromide HFA
Tóm tắt
▴ Ipratropium bromide is a nonselective antagonist of the muscarinic receptors located on airway smooth muscle, and is delivered via a metered-dose inhaler (MDI). ▴ Because of the requirement to phase out chlorofluorocarbon (CFC)-propelled MDIs, the ipratropium bromide inhalation aerosol MDI has been redesigned with a hydrofluoroalkane as the propellant (ipratropium bromide HFA). Ipratropium bromide HFA has recently been approved in the US for the maintenance treatment of bronchospasm associated with COPD. ▴ Ipratropium bromide HFA 42μg four times daily (one dose [42μg] is delivered via two puffs of the inhaler) demonstrated comparable efficacy to that of ipratropium bromide CFC 42μg four times daily, as measured by spirometric testing, in a large, randomized, double-blind, placebo-controlled, 12-week trial in patients with stable COPD. ▴ Similarly, four-times-daily ipratropium bromide HFA 42μg and ipratropium bromide CFC 42μg provided a comparable degree of bronchodilation in patients with stable COPD during a 1-year, open-label study primarily designed to assess safety. ▴ In both studies, the tolerability profiles of ipratropium bromide HFA and ipratropium bromide CFC were comparable. The most common adverse events were related to respiratory system disorders. During the 1-year study, dry mouth was reported by 1.3% and 0.7% of patients in the ipratropium bromide HFA or ipratropium bromide CFC groups.
Tài liệu tham khảo
GOLD Scientific Committee. Global initiative for chronic obstructive lung disease — Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Updated 2004. Executive summary [online]. Available from URL: http://goldcopd.com/es2004clean.pdf [Accessed 2005 Feb 15]
National Collaborating Centre for Chronic Conditions. Chronic obstructive pulmonary disease. National clinical guideline on management of chronic obstructive pulmonary disease in adults in primary and secondary care. Thorax 2004 Feb; 59 Suppl. 1: 1–232
Huchon G, Hofbauer P, Cannizzaro G, et al. Comparison of the safety of drug delivery via HFA- and CFC-metered dose inhalers in CAO. Eur Respir J 2000 Apr; 15(4): 663–9
Forte R, Dibble C. The role of international environmental agreements in metered dose inhaler technology changes. J Allergy Clin Immunol 1999; 104(6): S217–20
Brambilla G, Ganderton D, Garzia R, et al. Modulation of aerosol clouds produced by pressurised inhalation aerosols. Int J Pharm 1999 Sep 10; 186(1): 53–61
American Thoracic Society and European Respiratory Society. Standards for the diagnosis and management of patients with COPD [online]. Available from URL: http://www.thoracic.org/COPD/pdf/copddoc.pdg [Accessed 2005 Feb 15]
Boehringer Ingelheim International GmbH. Atrovent® HFA (ipratropium bromide HFA) Inhalation Aerosol [online]. Available from URL: http://www.bidocs.com/renetnt:/Prescribing+Information/PIs/Atrovent+HFA/lOOOSOOl_US_l.pdf?DMW_FORMAT=pdf [Accessed 2005 Mar 8]
Brazinsky SA, Lapidus RJ, Weiss LA, et al. One-year evaluation of the safety and efficacy of ipratropium bromide HFA and CFC inhalation aerosols in patients with chronic obstructive pulmonary disease. Clin Drug Invest 2003; 23(3): 181–91
American Society of Health-System Pharmacists. Ipratropium bromide. AHFS Drug Information. 2005 ed. Bethesda (MD): American Society of Health-System Pharmacists, Inc., 2005: 1246–52
Friedman M, Littner M, Ghafouri M, et al. Ipratropium bromide HFA MDI 42 micrograms is clinically comparable to ipratropium bromide CFC MDI 42 micrograms in the treatment of COPD [abstract]. Am J Respir Crit Care Med 2001 Apr; 163 (5 Suppl. Pt 2): A278
Cuvelier A, Iacono P, Guemas E, et al. Ipratropium bromide MDI containing HFA propellant is as safe and effective as the CFC formulation: a dose confirmation study in patients with COPD [abstract]. Am J Respir Crit Care Med 1998 Mar; 157 (Suppl. Pt 2): A800
Taylor J, Kotch A, Rice K, et al. Ipratropium bromide hydrofluoroalkane inhalation aerosol is safe and effective in patients with COPD. Chest 2001 Oct; 120(4): 1253–61