J. Lulling

Early Bronchodilating Effect of Oxitropium Bromide in Comparison with Ipratropium Bromide

The bronchodilating effects of a metered aerosol dose of 40 micrograms ipratropium bromide and of 200 micrograms oxitropium bromide are similar 15 min. after administration. The bronc hodilating activity of ipratropium bromide appears earlier (i.e., 75-90 s after administration) than that of oxitropium bromide but later than that of ibuterol, a beta2-agonist. Ipratropium bromide administered at the close of 80 micrograms provokes a bronchodilation about double of that obtained with 40 micrograms. An adaptation of the usual dosage should be considered.

Controlled trial of the effect of repeated administration of ipratropium bromide on ventilatory function of patients with severe chronic airways obstruction

A trial was designed to assess whether repeated administration of ipratropium bromide for two weeks produced greater improvement than was obtained after a single dose. The effect of ipratropium bromide was compared with that of a placebo during a double-blind cross-over randomized trial in patients with advanced chronic airways disease in a stable state. Ipratropium bromide and placebo were both administered by metered dose inhaler for 14 days. There was a slight statistically significant improvement of conductance, thoracic gas volume, FEV1 and VC after inhalation of ipratropium bromide, but repeated doses of the drug did not produce progressive improvement.

Bronchodilating and Density Dependence Effects of Fenoterol, Ipratropium Bromide and Duovent in Reversible Chronic Obstructive Pulmonary Disease

The bronchodilating effect of Duovent (0.2 mg fenoterol +0.8 mg ipratropium bromide) was compared with that of each of its components at the same doses. Twenty patients were included in the trial. Maximum expiratory flow-volume curves with air and helium-oxygen, intrathoracic gas volume and airway conductance were used for assessing the bronchomotor tone before and 15, 30, 60, 240 and 360 min after drug administration. All the drugs showed a significant bronchodilating effect. No differences between Duovent and fenoterol or ipratropium bromide were observed except a slight but statistically significant greater decrease of ITGV with Duovent. When expressing the data as percentage variation of the initial values, Duovent induced a better effect than the other drugs. The evaluation of density dependence was highly disappointing, and no conclusion can be drawn.

Comparison of the bronchodilating effect of two doses of a sustained release theophylline

In order to assess the dose/response ratio of two different doses of theophylline, the effects of two periods of 4-day treatment with 300 and 450 mg sustained release anhydrous theophylline (Theodur, Astra, Sweden) b.i.d. in 16 in-patients with reversible chronic obstructive lung disease in a stable state were investigated in a double-blind randomized crossover study. On the 4th day in each treatment period, ventilatory function parameters (FEV1, FVC, PEFR, MEF25, MEF50), theophylline serum concentration and blood gases were measured. Asthma symptoms, beta 2-adrenergic aerosol use significantly different from its value before treatment: the mean FEV1 increase during the 300-mg period reached 12% and during the 450-mg period 15%. The mean difference in theophylline serum concentration between the periods of 300 and 450 mg reached approximately 2 micrograms/ml, but a significant difference could not be demonstrated between both treatment periods, neither in the mean ventilatory parameters, nor in the patients preference. In spite of the use of a sustained release preparation, variations of serum levels of theophylline were observed individually throughout a 12-hour observation period: the extent of those variations differs from one patient to another.