ATS Pulmonary Function Laboratory Manual

ATS Pulmonary Function Laboratory Management & Procedure Manual | 3rd Edition

APPENDIX 12.5  Example of Doubling and Quadrupling Dose Protocols for Methacholine Challenge Test (one minute) 1. The table below provides doubling and quadrupling dosing protocols for using the AeroEclipse ® Breath Actuated Nebulizer with one minute of tidal breathing. 2. AeroEclipse ® Breath Actuated Nebulizer characteristics and related calculations: 2.1. Rate of output from breath simulator using 16 mg/ml solution of methacholine: 2.70 mg/min divided by 16 mg/ml = 0.16875 ml/min 2.2 Respirable fraction (RF, droplets < 5 m): 76% or 0.76 2.3 Ti/Ttot: 0.4 2.4 Breathing 16 mg/ml for one minute, the delivered dose would be: Output × RF = 0.16875 ml/min × 0.76 = 0.12825 ml/min 2.5 For other dilutions: Dose (μg) = concentration in nebulizer in mg/ml × 0.12825 ml/min × 1 min × 1,000

Doubling Dose Protocol

Quadrupling Dose Protocol

Concentration (mg/ml)

Dose (μg)

Concentration (mg/ml)

Dose (μg)

0.015625 0.03125

2 4 8

0.015625

2 8

0.0625

0.0625

0.25

32

0.125

16 32 64

1 4

128 512

0.25

0.5

1 2 4

128 256 512

140