ACUTE PULMONARY EFFECTS OF 3 NEBULIZERS FOR ADMINISTERING AEROSOL PENTAMIDINE - COMPARISON OF PARINEB TO FISONEB AND RESPIRGARD-II

We conducted a prospective, unblinded, nonrandomized, multiple crossov er study to assess the acute pulmonary effects of a new jet nebulizer- Parineb, comparing it to Respirgard II (jet nebulizer) and Fisoneb (ul trasonic nebulizer) for administering aerosol pentamidine (AP), Twenty -three HIV patients received AP at 60 mg dissolved in 3 ml sterile wat er with Parineb and Fisoneb and 300 mg dissolved in 5 ml sterile water with Respirgard II on three successive clinic visits. Twelve patients known to develop bronchospasm with AP received 200 mu g of salbutamol as premedication for all three nebulizers. Eleven subjects received A P without bronchodilator premedication, All subjects had a reduction i n flow rates with AP. No significant difference was noted in the reduc tion of flow rates between the three nebulizers in those patients with out prior history of bronchospasm with AP. However, there was a signif icantly greater reduction in flow rates with Parineb in patients with known AP-induced bronchospasm despite premedication with bronchodilato r. This decrease in flow rates with Parineb was not felt by patients b ased on the subjective rating of cough using a visual analog score whe n compared to the other two nebulizers. Parineb should be used cautiou sly in individuals with known AP-induced bronchospasm.