Fallat RJ, Kandal K, Brown CR, Harris RA, Price KJ, Wesley AM; International Conference on AIDS.
Int Conf AIDS. 1993 Jun 6-11; 9: 374 (abstract no. PO-B10-1436).
California Pacific Medical Center, San Francisco.
OBJECTIVE: To measure levels of pentamidine concentrations in BAL specimens from subjects receiving aerosolized P from Neb or from MDI, which may provide a convenient, more effective and less costly alternative to Neb for PCP prophylaxis. METHODS: An MDI capable of delivering 1.1 mgs of P per puff with 30% in the respirable range of 1-5um MMAD was tested. In our prior studies, 14 healthy HIV+ subjects inhaled 120 puffs of P over 40 min. 7 subjects inhaled 300 mg P from Neb over 40 min and 7 subjects inhaled 240 puffs over 2-4 hrs. Albuterol was given prior to dosing in all subjects. BAL with 180 ml saline was performed 24 hrs. and 28 days after dosing. BAL was centrifuged and P was measured in supernatant (S) and cell pellet (C) by high performance liquid chromatography. Similar levels of P were found in S & C in all 3 groups (PoB3295, Int'l Conf on AIDS, 1992). In the current study 35 AIDS patients eligible for PCP prophylaxis were randomized to 300 mg Neb on days 1 & 28 or 120 puffs from MDI followed by 8 or 24 puffs/d for 56 days. BALs were done on days 2, 28 & 56 prior to Neb dose or daily puffs. Two patients were dropped from the study: one for non-compliance and another after diagnosis of PCP from 24 hr BAL. RESULTS: As shown in table, BAL levels @ 24 hrs are similar to those in prior studies of healthy subjects. At 28 & 56 days levels of P in S were significantly higher in the two MDI groups than in the Neb group. The P in C was similar between Neb & 8 puffs, but significantly higher in the 24 puff group. TABULAR DATA, SEE ABSTRACT VOLUME. Moderate cough was reported in one patient in each MDI group, moderate asthma in one patient on 24 puffs, but treatment was not altered. CONCLUSION: P delivered by either 8 or 24 puffs/d by MDI is well tolerated and results in significantly elevated P in BAL after 28 and 56 days of daily dosing. Prophylaxis may be improved by use of MDI rather than Neb. More prolonged evaluations are indicated and ongoing.
Publication Types:
Keywords:
- Administration, Inhalation
- Aerosols
- Albuterol
- Humans
- Lung
- Lung Diseases, Obstructive
- Metered Dose Inhalers
- Nebulizers and Vaporizers
- Pentamidine
- Pharmaceutical Preparations
Other ID:
UI: 102204362
From Meeting Abstracts