title: [Osmolarity of solutions used in nebulization].
abstract: Inhaled medications are widely used in patients suffering from bronchial diseases. Beside their pharmacological properties, nebulised solutions have physico-chemical characteristics that can alter bronchial reactivity. Non-isotonic solutions can induce a bronchial hyperresponsiveness and/or a severe bronchonconstriction. Nevertheless, multiple drugs are used for nebulisation despite their unknown osmolarity. The aim of this study was to measure the tonicity of drug solutions commonly used for nebulisation in patients suffering from bronchial disease. Drug solutions were prepared either according to manufacturer recommendations or by diluting the stock in 5 ml of NaCl (0.9%) or H2CO3 (0.14%). Although bronchodilatator solutions (i.e. salbutamol, terbulatine, ipratropium bromide) were nearly isotonic, some drugs prepared for nebulisation had either a very high (e.g. mesna, netilmicine) or a very low (e.g. gomenol, sodium cromoglycate) tonicity. These values may be responsible for bronchoconstriction. Some hypertonic solutions, prepared with drugs such as acetylcytein or netilmycin, are not commercialised for nebulisation but are commonly used for aerosol therapy. In addition, solutions initially isotonic could become significantly hypertonic towards the end of nebulisation. Taken together, these results suggest that non-isotonic solutions should be used with caution specially in patients with bronchial hyperresponsiveness, even when aerosol therapy is prescribed for upper airways.
authors.affiliation: CHU de Bordeaux, Hôpital du Haut-Lévêque, Pessac.
authors.forename: L
authors.initials: L
authors.lastname: Portel
authors.forename: J M
authors.initials: JM
authors.lastname: Tunon de Lara
authors.forename: J M
authors.initials: JM
authors.lastname: Vernejoux
authors.forename: I
authors.initials: I
authors.lastname: Weiss
authors.forename: A
authors.initials: A
authors.lastname: Taytard
mesh_terms: D000111:Acetylcysteine / Q000737:chemistry; D000280:Administration, Inhalation; D000336:Aerosols / Q000008:administration & dosage / Q000737:chemistry; D000420:Albuterol / Q000737:chemistry; D018927:Anti-Asthmatic Agents / Q000737:chemistry; D001639:Bicarbonates; D001982:Bronchial Diseases / Q000188:drug therapy; D016535:Bronchial Hyperreactivity / Q000139:chemically induced; D016084:Bronchoconstriction / Q000187:drug effects; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000737:chemistry*; D002021:Buffers; D055598:Chemical Phenomena; D002627:Chemistry, Physical; D004205:Cromolyn Sodium / Q000737:chemistry; D005100:Expectorants / Q000737:chemistry; D005839:Gentamicins / Q000737:chemistry; D006801:Humans; D006982:Hypertonic Solutions / Q000737:chemistry; D009241:Ipratropium / Q000737:chemistry; D007552:Isotonic Solutions / Q000737:chemistry; D015080:Mesna / Q000737:chemistry; D009330:Nebulizers and Vaporizers; D009428:Netilmicin / Q000737:chemistry; D009822:Oils, Volatile / Q000737:chemistry; D009994:Osmolar Concentration; D012965:Sodium Chloride; D013726:Terbutaline / Q000737:chemistry; D013729:Terpenes / Q000737:chemistry
chemical_list: D000336:Aerosols; D018927:Anti-Asthmatic Agents; D001639:Bicarbonates; D001993:Bronchodilator Agents; D002021:Buffers; D005100:Expectorants; D005839:Gentamicins; D006982:Hypertonic Solutions; D007552:Isotonic Solutions; D009822:Oils, Volatile; D013729:Terpenes; D012965:Sodium Chloride; D009428:Netilmicin; C013545:gomenol; D009241:Ipratropium; D013726:Terbutaline; D015080:Mesna; D004205:Cromolyn Sodium; D000420:Albuterol; D000111:Acetylcysteine
vernacular_title: Osmolarité des solutions utilisées en nébulisation.