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2. A pilot study of aerosolized amiloride for the treatment of lung disease in cystic fibrosis

Author

Knowles, Michael R., Church, Nina L., Waltner, William E., Yankaskas, James R., Gilligan, Peter, King, Malcolm, Edwards, Lloyd J., Helms, Ronald W., and Boucher, Richard C.

Subjects
Sodium channels -- Physiological aspects, Lung diseases, Aerosol therapy -- Research, Amiloride -- Health aspects, Cystic fibrosis -- Care and treatment
Abstract

One consequence of cystic fibrosis is the excessive absorption of sodium by cells lining the respiratory tract, which may contribute to the drying of airway secretions. The effects of aerosolized amiloride, a substance that blocks sodium channels, was tested in 14 cystic fibrosis patients in a randomized study. Each patient underwent two 25-week treatments, one with amiloride and one with only the vehicle (the inactive substance that carries the amiloride). The drug or placebo was administered four times each day. Tests of lung function were performed and symptoms of pulmonary dysfunction noted. Results showed that forced vital capacity (the amount inhaled by forcible inhalation) decreased almost twice as much from the baseline level during treatment with vehicle than with amiloride. The decrease in forced expiratory volume in one second was not different for vehicle and amiloride. The rheologic values (a measure of flow properties) values of sputum, including elasticity and viscosity, approximated normal values for patients during amiloride treatment, while the solid content of sputum did not change during the two periods. Cough clearance also improved with the drug. It appears that amiloride is a moderately effective agent for treating adults with lung disease resulting from cystic fibrosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1990

4. Tobramycin Administrationc and Blood Sampling through a Dual-Lumen Peripheral Intravenous Catheter

Author

Pleasants, Roy A., Williams, Dennis M., Fus, Andrea S., Leathers, Cathy M., and Waltner, William E.

Abstract

The objective of this study was to determine if a peripheral dual-lumen catheter could be used for accurate tobramycin blood concentration measurement when drug administration and blood sampling were undertaken through separate lumens of the catheter. Eleven adult volunteers received tobramycin 1.5 mg/kg iv infused over 30 minutes through the distal lumen of the dual-lumen catheter every eight hours for two doses. Multiple blood samples were obtained concurrently from the proximal lumen of the catheter and a single-lumen catheter in the contralateral arm after each dose. Blood samples were also obtained through the distal lumen before and 30 minutes after the end of the infusion. Accurate blood samples were obtainable through the dual-lumen catheter in only 5 of 11 subjects due to either infiltration or difficulties in catheter placement. In the subjects from whom accurate blood samples were obtained, approximately 20 minutes postinfusion was the amount of time required before measured tobramycin serum concentrations were similar between the arm in which the drug was infused (site of the dual-lumen catheter) and the contralateral arm. At standard times for obtainment of trough (just prior to the infusion) and peak (30 minutes after the end of a 30-minute infusion) tobramycin serum concentrations from the proximal lumen of the dual-lumen catheter were numerically similar to those obtained from the contralateral arm. This preliminary study indicates that the dual-lumen catheter provides accurate aminoglycoside concentrations when patent relative to blood withdrawal and if peak blood samples are obtained at least 30 minutes postinfusion through the recommended lumen. However, further study in a larger number of subjects is required before routine use of this device can be recommended.

Published
1989
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