Acute Asthma in Young Adults in Out patient Department: Bronchodilator (Salbutamol) response by Pressurized Metered Dose Inhaler (pMDI) with Spacer and Dry Powder Inhaler (DPI): Efficacy assessment
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 4
Abstract
Background: Asthma is a chronic inflammatory disease of the airway with relapse and remission. There are different forms or variants of asthma eg: Intermittent Asthma, Persistent Asthma. Loss of control of any form or variant of asthma is termed as Acute exacerbation: which may cause mild to life threatening attack. Salbutamol inhalation is the key to control the acute attack. With its own advantages and disadvantages different delivery systems have been developed for asthma medications. Efficacy assessment compared between pMDI with Spacer and DPI(Aerolizer) about bronchodilator response in mild to moderate acute exacerbation of Asthma in young patients(19 years to 40 years) at out patient basis. Patients with severe acute exacerbation were excluded. Methods: This observational study was done at outpatient basis in Brahmanbaria Medical College Hospital, Concept Hospital, Feni & National Hospital, Dagonbhuiyan, Feni, Bangladesh and the sample was 100 Acute Asthma patients over a period of six months from January 2017 to July 2017. The patients were selected by prediagnosed Asthma patients as Acute exacerbation of Asthma by typical symptoms eg: Mild exacerbation: patient was dyspnoeic but can complete sentences and Moderate exacerbation; patient was more dyspnoeic and can,t complete a sentence in one breath. Initial peak expiratory flow rate (PEFR) was recorded. Randomly distributed two groups of equal number of patients received 500 micro-gm of salbutamol either by MDI with spacer and DPI (Aerolizer).Subsequent Subjective assessment were done by patient,s clinical status and objective follow-up were done by peak flow meter to record PEFR. Results: The subjective and objective improvement were observed with pMDI with spacer and DPI evident by symptoms and PEFR. Conclusion: Dry powder inhaler is better compliant in younger patient as it is effort dependent with greater Peak Inspiratory Flow Rate (PIFR) usually 60L/min or higher, measured by In-Check DIAL. However this study showed that in acute Asthma where there is loss of control equal amount of drug delivered by MDI with spacer showed better bronchodilator response.
Authors and Affiliations
Dr Sahedul Islam Bhuiyan, Dr Md Abu Sayed, Dr Jahanara Aktar, Dr Muhammad Jahangir Kabir, Dr Md Shihab Uddin, Dr Muhammad Saiyedur Rahman
Keywords
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- EP ID EP370613
- DOI 10.9790/0853-1704066266.
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