Pharmacotherapy of pediatric lung disease: differences between children and adults.

Drug dosages for infants and children differ significantly from those used in adults (Table 5). This is due to normal developmental physiologic differences that affect absorption, distribution, and clearance. In general, infants and children require higher dosages of many therapeutic agents on a weight basis.

Association of HLA DR1 with high D-penicillamine binding to monocytes in females.

Binding of D-Penicillamine (D-Pen) to human monocytes was examined by flow cytometry with fluorescent D-Pen conjugate. Cells from HLA DR1-positive healthy females bound significantly more D-Pen than cells from DR1-negative healthy females (P = 0.015), and DR1 was associated with the highest binding among HLA DR antigens.

Cromolyn sodium: a review of mechanisms and clinical use in asthma.

The cellular and clinical pharmacology of cromolyn sodium are reviewed. Cromolyn sodium inhibits the release of mediators of inflammation, induced by specific antigens as well as nonspecific mechanisms, such as exercise, from mast cells. Cromolyn may also inhibit the activity of other cell types that produce inflammation.

Evaluation of determination of theophylline concentrations by Seralyzer.

Determination of theophylline concentrations by Seralyzer in 28 paired serum and plasma samples disclosed almost identical results. Comparison of determinations by Seralyzer and enzyme-multiplied immunoassay in 31 paired serum samples disclosed significant underestimation by Seralyzer when recalibrated whenever results of analysis of a 15-micrograms/mL control exceeded limits of +/- 3 micrograms/mL. Determinations by Seralyzer did not differ significantly from enzyme-multiplied immunoassay with narrower limits of 15 +/- 2 micrograms/mL for Seralyzer calibration for 18 paired samples.

Comparison of the effects of intravenously administered aminophylline and inhaled isoproterenol on normal airways.

Although beta-agonists and anticholinergics have been well documented to alter the resting tone in normal airways, the effects of aminophylline on normal airway function is controversial. We therefore studied the effects of intravenously administered placebo and aminophylline, inhaled isoproterenol, and intravenously administered aminophylline plus inhaled isoproterenol in 8 nonasthmatic subjects using full and partial flow-volume curves, plethysmography, and respiratory resistance as measured by forced oscillation. Isoproterenol, as has been demonstrated previously, caused improvement in FEV1 FEF50, and the flow of a partial flow-volume curve at 75% of the VC (PFEF75).

Ranitidine at very large doses does not inhibit theophylline elimination.

While most controlled studies in humans indicate that ranitidine does not alter drug metabolism, there is some evidence that ranitidine may have this property. If ranitidine does inhibit drug metabolism in a predictable manner, such an effect might be expressed at higher ranitidine doses. Our study was designed to contrast the effects of large doses of ranitidine (1200 and 4200 mg/day) and cimetidine (1200 mg/day) on theophylline elimination.

New beta 2-adrenergic agonist aerosols.

The beta 2-adrenergic agonists are reviewed in terms of their dose-response characteristics, and two newer agents, fenoterol hydrobromide and bitolterol mesylate aerosols, are reviewed in relation to older agents. The fenoterol aerosol contains a more potent beta 2-adrenergic agonist dose per puff than the other aerosols but, when given in equipotent doses, offers no advantage over available agents. Bitolterol mesylate is a prodrug that is hydrolyzed to the active beta 2-adrenergic agonist colterol by lung esterases.

Lack of significant arrhythmogenicity from chronic theophylline and beta-2-adrenergic combination therapy in asthmatic subjects.

We monitored 14 asthmatic subjects (aged 18 to 60 years), with multiple 24-hour electrocardiogram (Holter) recordings, who were taking continuous sustained-release theophylline and beta-2-adrenergic therapy for control of their symptoms. All of the patients were enrolled in an efficacy study for the antiasthmatic drug lodoxamide. No patient demonstrated intrinsic cardiac disease by history or by a standard 12-lead electrocardiogram recording prior to entry into the study.

Susceptibility to IDDM is marked by MHC supratypes rather than individual alleles.

107 patients with insulin-dependent diabetes mellitus (IDDM) were typed for HLA A, B, C-, and DR antigens, and for complement C4A, C4B, and Bf alleles, and the results were compared with those of a combined reference group of 332 appropriately matched healthy subjects. Supratypes (allelic combinations) were identified from the phenotype of each group, and it was shown that the frequency of several supratypes is increased in patients with IDDM, in particular supratypes (A1 Cw7) B8 C4AQ0 C4B1 BfS DR3 (P = 0.0001), (A30 Cw-) B18 C4A3 C4BQ0 BfF1 DR3 (P = 0.

Antibiotic use in cystic fibrosis.

Chronic pulmonary infections contribute significantly to the morbidity and mortality of patients with CF. The primary pathogens are Pseudomonas aeruginosa (PA) and Staphylococcus aureus. Hemophilus influenzae has been isolated from a significant number of patients also.

Effects of theophylline on inhaled methacholine and histamine in asthmatic children.

The effects of a therapeutic serum theophylline concentration on inhaled methacholine and histamine were studied in 8 stable, moderately severe asthmatic children 8 to 15 yr of age. Placebo or theophylline in a hydroalcoholic solution was administered in a double-blind fashion, and standard histamine and methacholine challenges were performed following both placebo and theophylline. Serum theophylline concentration averaged 13 mg/L (range 4.