Abstract：
BACKGROUND:Dyspnea significantly impacts quality of life and is one of the most common symptoms in advanced illness. Systemically-administered opioids and benzodiazepines have been the most studied and utilized pharmacologic treatments for refractory dyspnea. Less attention has been given to the use of these medications and others when nebulized. This article presents a review of the literature on the use of nebulized medications for the treatment of dyspnea related to cancer, chronic obstructive pulmonary disease, cystic fibrosis, interstitial lung disease, or experimentally-induced dyspnea. METHODS:A systematic review of peer-reviewed literature was conducted using Medline/PubMed, CINAHL, Cochrane, and Google Scholar. RESULTS:Thirty-nine publications were included in this review, including 17 high-quality clinical research studies, as defined by the GRADE system. The evidence for nebulized morphine remains mixed, whereas a potential benefit was suggested for nebulized furosemide, hydromorphone, and fentanyl. No conclusions could be drawn as to which disease population derived greatest benefit from nebulized medications, or whether jet or ultrasonic nebulizers were more effective for the delivery of these medications. CONCLUSIONS:More research is needed to assess the characteristics of specific diseases and the combination of different nebulizers and medications that may yield the greatest benefit, and to assess the safety and efficacy of the chronic use of nebulized opioids and furosemide. Until larger, longer-term studies are completed, the use of nebulized medications to treat dyspnea should be assessed on a case-by-case basis and may be considered if the hoped-for benefits outweigh potential harm.
journal_name
J Aerosol Med Pulm Drug Delivjournal_title
Journal of aerosol medicine and pulmonary drug deliveryauthors
Boyden JY,Connor SR,Otolorin L,Nathan SD,Fine PG,Davis MS,Muir JCdoi
10.1089/jamp.2014.1136subject
Has Abstractpub_date
2015-02-01 00:00:00pages
1-19issue
1eissn
1941-2711issn
1941-2703journal_volume
28pub_type
杂志文章,评审abstract：BACKGROUND:Understanding the regional partition of deposition of inhaled particles within the lung is important for improving targeted delivery of inhaled aerosolized drugs. One factor affecting regional deposition is gravity. As the lung deforms under its own weight, changes in lung volume, in airway geometries, and i...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2014.1189
更新日期：2015-12-01 00:00:00
abstract：: Background: Many countries have introduced a compulsory use of community masks for certain public areas during the SARS-CoV-2 pandemic. Different manufacturers offer reusable community masks in large quantities. The efficacy of these masks, however, is unknown. ...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2020.1635
更新日期：2020-09-23 00:00:00
abstract：:This article provides a concise review of the use of magnetic resonance imaging (MRI) for measurement of regional aerosol deposition in the lungs. Basic aspects of MRI and its use in lung imaging and measurement of regional ventilation are introduced. Imaging of hydrogen protons (water) and inhaled hyperpolarized gase...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章,评审
doi：10.1089/jamp.2011.0897
更新日期：2012-04-01 00:00:00
abstract：PURPOSE:The objective of this study was to determine optimal aerosol delivery conditions for a full-term (3.6 kg) infant receiving invasive mechanical ventilation by evaluating the effects of aerosol particle size, a new wye connector, and timing of aerosol delivery. METHODS:In vitro experiments used a vibrating mesh ...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2013.1077
更新日期：2014-10-01 00:00:00
abstract：BACKGROUND:Very little is known about the role of nasal morphology due to ethnic variation on particle deposition pattern in the sinonasal cavity. This preliminary study utilizes computational fluid dynamics (CFD) modeling to investigate sinonasal airway morphology and deposition patterns of intranasal sprayed particle...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2014.1205
更新日期：2016-04-01 00:00:00
abstract：BACKGROUND:The unit dose dry powder inhaler (UD-DPI) is being considered as an alternative inhaler platform that, if developed, has the potential to improve access to inhaled respiratory medicines in developing countries. AIM:This study compared the systemic exposure of fluticasone furoate after delivery from the UD-D...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章,随机对照试验
doi：10.1089/jamp.2016.1322
更新日期：2017-10-01 00:00:00
abstract：:Upper respiratory tract infections (URTIs), primarily acute rhinopharyngitis, tonsillitis, adenoiditis, and rhinosinusitis (RS), are major causes of morbidity in both children and adults of any age. In addition to the frequent occurrence of related medical problems and the associated socioeconomic costs, URTIs have a ...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章,评审
doi：10.1089/jamp.2016.1300
更新日期：2017-02-01 00:00:00
abstract：BACKGROUND:The Abbreviated Impactor Measurement (AIM) concept simplifies determination of aerodynamic size metrics for inhaler quality control testing. A similar approach is needed to compare in vitro particle size distribution metrics with human respiratory tract (HRT) deposition. METHODS:An abbreviated impactor base...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2011.0925
更新日期：2012-08-01 00:00:00
abstract：:The present study aimed at assessing the pharmacokinetics (PK) and safety pharmacodynamics (PD) of 24 microg formoterol delivered via a Novolizer and via an Aerolizer in healthy subjects. This was a randomized, open-label, crossover study. Beside PK, serum potassium, and glucose profiles, vital signs, and ECG were rec...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章,随机对照试验
doi：10.1089/jamp.2008.0690
更新日期：2008-09-01 00:00:00
abstract：BACKGROUND:Mechanically ventilated patients commonly suffer from ventilator-associated pneumonia, hypoxemia, and other lower respiratory tract infection as a result of pathogen colonization and poor sputum clearance. Consequently, there is a high rate of morbidity and mortality in these patients. Dry powder mannitol in...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2016.1320
更新日期：2017-04-01 00:00:00
abstract：: Background: The photo reflection method (PRM) is used to measure light reflected from particles released from dry powder inhalers (DPIs). This simple method depicts time trajectories of released drugs; however, it underestimates the number of particles at high peak inhalat...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2020.1610
更新日期：2020-11-04 00:00:00
abstract：BACKGROUND:Currently bronchial provocation testing (BPT) using mannitol powder cannot be performed in children under 6 years. A primary reason is it is challenging for children at this age to generate a consistent inspiratory effort to inhale mannitol efficiently from a dry powder inhaler. A prototype system, which doe...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2015.1208
更新日期：2015-12-01 00:00:00
abstract：BACKGROUND:High flow nasal cannula oxygen therapy (HFT) is increasingly used in intensive and emergency care departments. Patients suffering from respiratory failure, who are likely to benefit from HFT, may require aerosolized bronchodilators; therefore, combining nebulization with HFT may be relevant. This study aimed...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2015.1219
更新日期：2016-04-01 00:00:00
abstract：:Flexhaler is a multiple-dose, inspiratory flow-driven dry powder inhaler that is a newer version of Turbuhaler, and is identical to the Symbicort Turbuhaler. Sustained performance is of the utmost importance to ensure consistent drug delivery throughout the lifespan of the inhaler. We report functionality testing resu...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2008.0700
更新日期：2008-12-01 00:00:00
abstract：BACKGROUND:To our knowledge, quantification of intranasal deposition of aerosol generated by Accuspray(™) (AS) in children has never been published. We hypothesized that deposition would vary significantly with age and with placement of the device within, or outside, of the nostril. METHODS:We tested these hypotheses ...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2014.1174
更新日期：2015-10-01 00:00:00
abstract：BACKGROUND:Vitamin A (VA) is crucial for lung growth and development. In premature infants, inadequate VA levels are associated with an increased risk of bronchopulmonary dysplasia (BPD). Intramuscular VA supplementation has been shown to decrease the incidence of BPD, but is not widely used in the clinical setting due...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2017.1438
更新日期：2018-12-01 00:00:00
abstract：: Background: Many substances used in inhalation research are water soluble and can be administered as nebulized solutions. Typical examples are therapeutic, small-molecular agents, or macromolecules. Another category is a number of water-soluble agents used for airway diagn...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2019.1554
更新日期：2020-04-01 00:00:00
abstract：BACKGROUND:Small rodents continue to be the mainstay for the assessment of pharmacological and toxicological data of inhaled therapeutics. For meaningful interpretation of the results information about deposition of aerosol particles in the respiratory tract is warranted, but not trivial to obtain for animals with nose...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2011.0902
更新日期：2012-06-01 00:00:00
abstract：BACKGROUND:Secondary lung infections are the primary cause of morbidity associated with cystic fibrosis lung disease. Aerosolized antibiotic inhalation is potentially advantageous but has limited effectiveness due to altered airway aerodynamics and deposition patterns that limit drug access to infected regions. One pot...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2017.1412
更新日期：2018-08-01 00:00:00
abstract：BACKGROUND:Computer modeling is used to predict inhaled aerosol deposition in the lung based on definition of the aerosol characteristics and the breathing pattern and airway anatomy of the subject. Validation of the models is limited by the lack of detailed experimental data. Three-dimensional imaging provides an oppo...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2014.1191
更新日期：2015-12-01 00:00:00
abstract：: Background: Inhalation of medications is the cornerstone in the treatment of patients with lung diseases. A variety of inhalation devices exists and each device has specific requirements to achieve optimum inhalation of the drug. The goal of this study was to establish a c...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2017.1376
更新日期：2018-12-01 00:00:00
abstract：:The use of gamma camera imaging following the inhalation of a radiolabel has been widely used by researchers to investigate the fate of inhaled aerosols. The application of two-dimensional (2D) planar gamma scintigraphy and single-photon emission computed tomography (SPECT) to the study of inhaled aerosols is discusse...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章,评审
doi：10.1089/jamp.2011.0960
更新日期：2013-06-01 00:00:00
abstract：BACKGROUND:Inhaled alpha1-antitrypsin (AAT) is being developed for treatment of cystic fibrosis to protect the lungs from excessive free elastase. High drug costs mandate a very efficient aerosol system to deliver a high payload to the airways. The I-neb Adaptive Aerosol Delivery (AAD) System is a portable, electronic,...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2009.0793
更新日期：2010-04-01 00:00:00
abstract：:Since the early 1960s, there has been a continuous evolution in scientific understanding regarding bioequivalence (BE) of oral dosage forms, intermittently punctuated by some breakthrough research findings and conceptual advances. The accumulated knowledge from this body of research has been translated into a sophisti...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章,评审
doi：10.1089/jamp.2014.1144
更新日期：2014-12-01 00:00:00
abstract：BACKGROUND:Model predictions of regional deposition in the respiratory tract are useful in assessing factors that influence the effectiveness of aerosol delivery. Regional deposition models have previously been coupled with models of mucous production and clearance to estimate initial concentrations of drug deposited i...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2017.1377
更新日期：2018-02-01 00:00:00
abstract：BACKGROUND:The site of deposition in the respiratory tract for aerosolized, inhaled therapeutic drugs depends on both the particles' aerodynamic size and the patient's breathing pattern. METHODS:In 21 healthy subjects with normal lung function, we evaluated an extremely slow inhalation of a large 9.5-μm MMAD particle ...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2008.0711
更新日期：2010-12-01 00:00:00
abstract：PURPOSE:Many methods have been developed to evaluate dry powder inhalation techniques and their efficiency for disease control in asthma patients. However, it is difficult to apply these methods to clinical practice and research. In this study, we introduce a simple new method that can be applied to dry powder inhalati...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2014.1193
更新日期：2016-10-01 00:00:00
abstract：:Antibiotic-resistant bacterial infections have renewed interest in finding substitute methods of treatment. The purpose of the present in vitro study was to investigate the possibility of respiratory delivery of a Burkholderia cepacia complex (BCC) bacteriophage by nebulized aerosol administration. Bacteriophages in i...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2008.0701
更新日期：2008-12-01 00:00:00
abstract：BACKGROUND:Inhaled corticosteroid (ICS) therapy has improved the quality of life (QOL) for many asthmatics and reduced mortality rates associated with asthma. However, some patients do not obtain therapeutic benefit despite satisfactory adherence. OBJECTIVES:To determine whether asthmatic patients were using ICS devic...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2010.0868
更新日期：2011-12-01 00:00:00
abstract：BACKGROUND:Particle size and velocity are two of the most significant factors that impact the deposition of pressurized metered-dose inhaler (pMDI) sprays in the mouth cavity. pMDIs are prominently used around the world in the treatment of patients suffering from a variety of lung diseases such as asthma and chronic ob...
journal_title：Journal of aerosol medicine and pulmonary drug delivery
pub_type： 杂志文章
doi：10.1089/jamp.2015.1264
更新日期：2016-12-01 00:00:00
