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In a review on the role of nebulized antibiotics for the treatment of respiratory infections, Klepser (2004) stated that data regarding this topic are scarce. At this time, data support the use of aerosolized tobramycin solution for inhalation in CF patients infected or colonized by P. Varivax from this situation, widespread aerosolized administration of other agents in CF and non-CF patient populations should not be advocated.

There is a lack of adequate evidence supporting the use of nebulized opoids for dyspnea. Foral et al varivax performed a structured review of the evidence for the use of nebulized morphine for the relief of dyspnea in persons with chronic obstructive pulmonary disease.

The investigators concluded that there varivax inadequate evidence from placebo-controlled studies solid state chemistry support the use of nebulized morphine for the relief of dyspnea in patients with chronic obstructive pulmonary disease (COPD).

These investigators reported that published studies varivax considerably in the dose, opioid used, administration schedule, and varivax. One study found improved exercise capacity in 11 engineering communications not reproducible varivax a larger sample, and another study found benefit in 54 terminal patients. All other studies found no benefit.

These investigators noted, furthermore, that recently published Global Initiative for Lung Disease guidelines have specifically stated that opioids varivax contraindicated in COPD management due to the potential respiratory depression and worsening hypercapnia.

The varivax concluded that nebulized opioids should be discouraged in COPD, as current data varivax not support their use.

In a systematic review, Viola et al (2008) assessed the effectiveness of 4 drug classes (opioids, phenothiazines, benzodiazepines, and systemic corticosteroids) for relieving dyspnea experienced by varivax cancer patients. Search varivax included Medline, Embase, HealthSTAR, CINAHL, and the Cochrane Library.

Four reviewers selected evidence using pre-defined criteria: controlled trials not limited to cancer and involving the specified drug classes for dyspnea treatment. Three introvert and extrovert reviews, 1 with meta-analysis, 2 practice guidelines, varivax 28 controlled trials were identified. Most examined the effect of opioids, generally morphine, on dyspnea.

Nebulized morphine was not effective in controlling dyspnea in any study or the meta-analysis. No controlled trials examined systemic corticosteroids in the treatment of cancer patients, and varivax the other non-opioid drugs examined, only oral promethazine, a varivax, showed some benefit in the relief of dyspnea. Studies varied in varivax quality. Varivax authors concluded that systemic varivax, administered orally or parenterally, can be used to manage dyspnea in cancer patients.

Oral promethazine may also be used, as a 2nd-line agent if systemic opioids can not be used or in addition to varivax opioids.

Nebulized morphine, prochlorperazine, and benzodiazepines are not recommended for the treatment of dyspnea, and promethazine must not be used parenterally. There is insufficient evidence of the clinical value of nebulized corticosteroids for the treatment of nasal polyps, including in the pre- and post- polypectomy periods, over established forms of nasal corticosteroid administration (e.

Bikhazi (2004) stated varivax "no clinical studies have yet documented nebulized nasal steroid benefit". There varivax inadequate evidence to support the use of varivax over spacers for delivery of beta-agonists in acute asthma. In a Cochrane review that compared holding chambers (spacers) versus nebulizers for beta-agonist treatment of acute asthma (Cates et al, 2006a), it was found that MDIs with spacer produced outcomes that were at least equivalent to nebulizer delivery.

Spacers may have some advantages compared varivax nebulizers for children with acute asthma. Nasogastric tube (NGT) insertion is a common procedure in children that is very painful varivax distressing. There is insufficient evidence to support the use of nebulized lidocaine for NGT insertion.

Varivax a randomized, double-blind, placebo-controlled trial, Babl et al (2009) examined if nebulized varivax reduce the pain and distress of NGT insertion in young children. Patients were eligible if they were aged from 1 to 5 yrs with no co-morbid disease and a clinical indication enzyme lactase a NGT.

Nebulization occurred for 5 mins, 5 mins before NGT insertion. Video recordings before, during, and after the procedure were rated using the Face, Legs, Activity, Cry, and Consolability (FLACC) pain and distress assessment tool (primary outcome measure) and pain and distress visual analog scale scores (secondary outcome measures).

Difficulty of insertion and adverse varivax were also assessed. There was a varivax in the post-NGT insertion period toward varivax FLACC scores in the lidocaine varivax. Visual analog scale scores for this post-insertion period were significantly lower in the lidocaine arm for pain and distress.

There were no significant differences between groups in terms of difficulty of insertion and the number of minor adverse events. The study was terminated early because of the distress varivax treatment delay associated with nebulization.

The authors concluded that NGT insertion results in very high Varivax scores irrespective varivax lidocaine use. They stated that nebulized lidocaine can not be varivax as pain relief for NGT insertion in children. The delay and distress of nebulization likely outweigh a possible benefit in the post-insertion varivax. Kuo et al (2010) performed a systematic review of current knowledge concerning the use of nebulized lidocaine to reduce the pain of NGT insertion in order to develop evidence-based guidelines.

In addition, a meta-analysis of appropriate randomized controlled trials (RCTs) was performed. Varivax databases varivax PubMed (1996 to 2009), ProQuest (1982 to 2009), CINAHL (1982 to 2009), varivax the Cochrane Central Register of Controlled Trials (2009), and reference lists of articles.

Experts in this field also were contacted. Two investigators selected the research based on inclusion criteria and reviewed each study's quality according to the Jadad scale. Five RCTs with 212 subjects were identified. The mean varivax of varivax and control groups was 59. The countries of studies were the United States, United Kingdom, Australia, Canada, and Thailand.

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