Author(s):
Jyothisree Vijay, Anjumol Raju, Athul Joseph, Aiswarya Ramesh, Nithya Haridas, Meenu Vijayan
Email(s):
meenuvijayan@aims.amrita.edu
DOI:
10.5958/0974-360X.2021.00307.3 
Address:
Jyothisree Vijay1, Anjumol Raju1, Athul Joseph1, Aiswarya Ramesh1, Nithya Haridas2, Meenu Vijayan1
1Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, Kerala, India-682041.
2Department of Pulmonology, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, Kerala, India-682041.
*Corresponding Author
Published In:
Volume - 14,
Issue - 3,
Year - 2021
ABSTRACT:
Background: The occurrence of exacerbation in these patients may result in worsening quality of life and a faster decline in lung function. Amongst the Indian population the prevalence of COPD is about 3% to 8% in males and 2.5% to 4.5% in females. Objective: The purpose of this study was to analyze the effectiveness of treatment and the quality of life of those patients who were admitted with a diagnosis of AECOPD to Amrita Institute of Medical Sciences and Research Centre, Kerala between October 2018 and April 2019. The patients selected were those who had received a combination of formoterol with budesonide to the standard treatment of salbutamol with ipratropium bromide nebulization. Methods: A total of 75 patients with diagnosis of acute exacerbation of COPD met the inclusion criteria. Their dyspnea symptoms, Arterial blood gas (ABG) values, PEFR values and their quality of life were compared on day of admission and day of discharge. The ADRs that occurred were also monitored during their stay at the hospital. Result: There was a significant change in the effectiveness parameters and the quality of life of the patients who were taking the treatment together. The ADRs observed were not severe. Conclusion: The use of the treatment combination showed a statistical significance in the patient’s condition hence showing that the addition of formoterol and budesonide to the standard therapy may be considered in the treatment of patients suffering from acute exacerbated COPD.
Cite this article:
Jyothisree Vijay, Anjumol Raju, Athul Joseph, Aiswarya Ramesh, Nithya Haridas, Meenu Vijayan. A Prospective Study to assess the impact of Formoterol and Budesonide Nebulization as add on therapy in the management of Acute Exacerbation of COPD in a Tertiary Care Hospital. Research J. Pharm. and Tech 2021; 14(3):1723-1728. doi: 10.5958/0974-360X.2021.00307.3
Cite(Electronic):
Jyothisree Vijay, Anjumol Raju, Athul Joseph, Aiswarya Ramesh, Nithya Haridas, Meenu Vijayan. A Prospective Study to assess the impact of Formoterol and Budesonide Nebulization as add on therapy in the management of Acute Exacerbation of COPD in a Tertiary Care Hospital. Research J. Pharm. and Tech 2021; 14(3):1723-1728. doi: 10.5958/0974-360X.2021.00307.3 Available on: https://www.rjptonline.org/AbstractView.aspx?PID=2021-14-3-96
REFERENCE:
1. Vestbo J, Anderson W, Coxson Ho et al. Evaluation of COPD longitudinally to identify predictive surrogate end-points (ECLIPSE). Eur Respir J. 2008; 31(4): 869-73.
2. Bhome AB. COPD in India: Iceberg or volcano? J Thorac Dis. 2012; 4(3): 298.
3. Lopez AD, Shibuya K, Rao C et al. Chronic obstructive pulmonary disease: current burden and future projections. Eur Respir J. 2006; 27(2): 397-412.
4. Stoller JK, Aboussouan LS. Alpha 1-antitrypsin deficiency. Lancet. 2005; 365(9478): 2225-36.
5. McCloskey SC, Patel BD, Hinchliffe SJ, Reid ED, Wareham NJ, Lomas DA. Siblings of patients with severe chronic obstructive pulmonary disease have a significant risk of airflow obstruction. Am J Respir Crit Care Med. 2001; 164(8): 1419-24.
6. Mercado N, Ito K, Barnes PJ. Accelerated ageing of the lung in COPD: new concepts. Thorax. 2015: Thoraxjnl-2014.
7. Landis SH, Muellerova H, Mannino DM et al. Continuing to Confront COPD International Patient Survey: methods, COPD prevalence, and disease burden in 2012–2013. Int J Chron Obstruct Pulmon Dis. 2014; 9: 597.
8. Regan EA, Lynch DA, Curran-Everett D et al. Clinical and radiologic disease in smokers with normal spirometry. JAMA Intern Med. 2015; 175(9): 1539-49.
9. Stern DA, Morgan WJ, Wright AL, Guerra S, Martinez FD. Poor airway function in early infancy and lung function by age 22 years: a non-selective longitudinal cohort study. The Lancet. 2007; 370(9589): 758-64.
10. Kohansal R, Martinez-Camblor P, Agustí A, Buist AS, Mannino DM, Soriano JB. The natural history of chronic airflow obstruction revisited: an analysis of the Framingham offspring cohort. Am J Respir Crit Care Med. 2009;180(1): 3-10.
11. Yin P, Jiang CQ, Cheng KK et al. Passive smoking exposure and risk of COPD among adults in China: the Guangzhou Biobank Cohort Study. The Lancet. 2007; 370(9589): 751-7.
12. Tager IB, Ngo L, Hanrahan JP. Maternal smoking during pregnancy. Effects on lung function during the first 18 months of life. Am J Respir Crit Care Med. 1995; 152(3): 977-83.
13. Paulin LM, Diette GB, Blanc PD et al. Occupational exposures are associated with worse morbidity in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2015; 191(5): 557-65.
14. Eisner MD, Anthonisen N, Coultas D et al. An official American Thoracic Society public policy statement: Novel risk factors and the global burden of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2010; 182(5): 693-718.
15. Marchetti N, Garshick E, Kinney GL et al. Association between occupational exposure and lung function, respiratory symptoms, and high-resolution computed tomography imaging in COPD Gene. Am J Respir Crit Care Med. 2014; 190(7): 756-62.
16. Orozco-Levi M, Garcia-Aymerich J, Villar J, Ramirez-Sarmiento A, Anto JM, Gea J. Wood smoke exposure and risk of chronic obstructive pulmonary disease. Eur Respir J. 2006; 27(3): 542-6.
17. Gan WQ, FitzGerald JM, Carlsten C, Sadatsafavi M, Brauer M. Associations of ambient air pollution with chronic obstructive pulmonary disease hospitalization and mortality. Am J Respir Crit Care Med. 2013; 187(7): 721-7.
18. Zhou Y, Zou Y, Li X et al. Lung function and incidence of chronic obstructive pulmonary disease after improved cooking fuels and kitchen ventilation: a 9-year prospective cohort study. PLoS med. 2014;11(3): e1001621.
19. Allinson JP, Hardy R, Donaldson GC, Shaheen SO, Kuh D, Wedzicha JA. The presence of chronic mucus hypersecretion across adult life in relation to chronic obstructive pulmonary disease development. Am J Respir Crit Care Med. 2016; 193(6): 662-72.
20. Guerra S, Sherrill DL, Venker C, Ceccato CM, Halonen M, Martinez FD. Chronic bronchitis before age 50 years predicts incident airflow limitation and mortality risk. Thorax. 2009; 64(10): 894-900.
21. Kim V, Han MK, Vance GB et al. The chronic bronchitic phenotype of COPD: an analysis of the COPDGene Study. Chest. 2011;140(3): 626-33.
22. De Marco R, Accordini S, Marcon A et al. Risk factors for chronic obstructive pulmonary disease in a European cohort of young adults. Am J Respir Crit Care Med. 2011;183(7): 891-7.
23. Drummond MB, Kirk GD. HIV-associated obstructive lung diseases: insights and implications for the clinician. Lancet Respir Med. 2014; 2(7): 583-92.
24. Byrne AL, Marais BJ, Mitnick CD, Lecca L, Marks GB. Tuberculosis and chronic respiratory disease: a systematic review. Int J Infect Dis. 2015; 32: 138-46.
25. American Lung Association Epidemiology and Statistics Unit. Trends in COPD (Chronic Bronchitis and Emphysema): Morbidity and Mortality. [cited 12 August 2016]; available from: https://www.lung.org/assets/documents/research/copd-trend-report. pdf
26. Menezes AM, Jardim JR, Pérez-Padilla R et al. Prevalence of chronic obstructive pulmonary disease and associated factors: the PLATINO Study in São Paulo, Brazil. Cad Saude Publica. 2005; (5): 1565-73.
27. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS medicine. 2006; 3(11): e442.
28. Halbert RJ, Natoli JL, Gano A, Badamgarav E, Buist AS, Mannino DM. Global burden of COPD: systematic review and meta-analysis. Eur Respir J. 2006; 28(3): 523-32.
29. Schikowski T, Sugiri D, Ranft U, Gehring U, Heinrich J, Wichmann HE, et al. Long-term air pollution exposure and living close to busy roads are associated with COPD in women. Respir Res.2005; 6(1):152.
30. Seemungal T, Harper-Owen R, Bhowmik A, Moric I, Sanderson G, Message S, et al. Respiratory viruses, symptoms, and inflammatory markers in acute exacerbations and stable chronic obstructive pulmonary disease. Am J Respir Crit Care Med.2001; 164(9):1618-23.
31. Feary JR, Rodrigues LC, Smith CJ, Hubbard RB, Gibson JE. Prevalence of major comorbidities in subjects with COPD and incidence of myocardial infarction and stroke: a comprehensive analysis using data from primary care. Thorax.2010: thx-2009.
32. Barnes PJ, Celli BR. Systemic manifestations and comorbidities of COPD. Eur Respir J. 2009; 33(5): 1165-85.
33. Gordon J, Panos RJ. Inhaled albuterol/salbutamol and ipratropium bromide and their combination in the treatment of chronic obstructive pulmonary disease. Expert Opin Drug Metab Toxicol. 2010; 6(3): 381-92.
34. Combivent Inhalation Aerosol Study Group. In COPD, a combination of ipratropium and albuterol is more effective than either agent alone: an 85-day multicenter trial. Chest. 1994; 105: 1411-9.
35. Calverley PM, Boonsawat W, Cseke Z, Zhong N, Peterson S, Olsson H. Maintenance therapy with budesonide and formoterol in chronic obstructive pulmonary disease. Eur Respir J.2003; 22(6): 912-9.
36. Welte T, Miravitlles M, Hernandez P, Eriksson G, Peterson S, Polanowski T, et al. Efficacy and tolerability of budesonide/ formoterol added to tiotropium in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2009; 180(8): 741-50.
37. Szafranski W, Cukier A, Ramirez A, Menga G, Sansores R, Nahabedian S, et al. Efficacy and safety of budesonide/formoterol in the management of chronic obstructive pulmonary disease. Eur Respir J. 2003; 21(1): 74-81
38. Karpel JP, Pesin J, Greenberg D, Gentry E. A comparison of the effects of ipratropium bromide and metaproterenol sulfate in acute exacerbations of COPD. Chest. 1990; 98(4): 835-9.
39. Tashkin DP, Rennard SI, Martin P, Ramachandran S, Martin UJ, Silkoff PE, et al. Efficacy and safety of budesonide and formoterol in one pressurized metered-dose inhaler in patients with moderate to very severe chronic obstructive pulmonary disease. Drugs. 2008; 68(14): 1975-2000.
40. Lulich KM, Goldie RG, Ryan G, Paterson JW. Adverse reactions to β 2-agonist bronchodilators. J Med Toxicol. 1986; 1(4): 286-99.