Document Detail


Acute effects of higher than standard doses of salbutamol and ipratropium on tiotropium-induced bronchodilation in patients with stable COPD.
MedLine Citation:
PMID:  19038356     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Knowledge on the effects of the additive bronchodilatory effects of short-acting agents on the top of the effect of long-acting bronchodilators is limited. In this trial, we examined the influence of higher than conventional doses of the short-acting inhaled beta(2)-adrenergic agent salbutamol and the short-acting anticholinergic drug ipratropium bromide on bronchodilation induced by a regular treatment with the long-acting anticholinergic drug tiotropium 18 microg/day in 30 patients with stable COPD. On 3 separate days, a dose-response curve to inhaled salbutamol (100 microg puff-1), ipratropium bromide (20 microg puff-1) or placebo was constructed 3h after inhalation of the last dose of tiotropium, using one puff, one puff, two puffs and two puffs, for a total cumulative dose of 600 microg salbutamol or 120 microg ipratropium bromide. Doses were given at 30-min intervals and measurements made 15 min after each dose. At the highest cumulative dose, salbutamol showed a trend to be more effective than ipratropium bromide in improving FEV(1) (0.157 L vs 0.125 L), and reducing sRaw (-4.52 kPa/s vs 3.57 kPa/s), although the differences between the two treatments were always not significant (p>0.05), whereas there was no substantial difference between the two drugs in changing FVC (0.179 L vs 0.168 L), IC (0.254 L vs 0.240 L), TGV (-0.444 L vs -0.441 L), TLC (-0.334 L vs -0.318 L) and RV (-0.467 L vs -0.498 L). Both drugs did not affect heart rate and SpO2. Our results indicate that there is not much difference in bronchodilation between adding higher than conventional doses of salbutamol or ipratropium bromide to tiotropium in patients with stable COPD. Effective improvement of the pulmonary function may be achieved in such a type of patients by adding salbutamol 600 microg or ipratropium bromide 120 microg to regular tiotropium. These is an interesting finding mainly for those COPD patients suffering from cardiovascular co-morbidities that are at highest risk of myocardial infarction, congestive heart failure, cardiac arrest and sudden cardiac death when treated with elevated doses of a beta(2)-agonist (EudraCT number: 2007-001597-82).
Authors:
Mario Cazzola; Pierachille Santus; Alice D'Adda; Silvia Pizzolato; Fabiano Di Marco; Stefano Centanni
Related Documents :
1864116 - Assessment of bronchodilator response to a beta-adrenergic delivered from an ultrasonic...
10190186 - The effect of maimendongtang on airway clearance and secretion.
18310516 - Adenosine-mediated alteration of vascular reactivity and inflammation in a murine model...
14693296 - Tolerability of short-term, high-dose formoterol in healthy volunteers and patients wit...
23605186 - Mycotoxicological control on raw material and tablets of cascara sagrada (rhamnus pursh...
25300506 - Lethal and sublethal effects of azadirachtin on the bumblebee bombus terrestris (hymeno...
Publication Detail:
Type:  Journal Article     Date:  2008-11-08
Journal Detail:
Title:  Pulmonary pharmacology & therapeutics     Volume:  22     ISSN:  1522-9629     ISO Abbreviation:  Pulm Pharmacol Ther     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-01     Completed Date:  2009-07-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9715279     Medline TA:  Pulm Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  177-82     Citation Subset:  IM    
Affiliation:
Unit of Respiratory Diseases, Department of Internal Medicine, University of Rome Tor Vergata, Rome, Italy. mcazzola@qubisoft.it
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Albuterol / administration & dosage,  pharmacology*
Bronchi / drug effects,  physiopathology*
Bronchodilator Agents / administration & dosage,  pharmacology*
Dose-Response Relationship, Drug
Female
Forced Expiratory Flow Rates / drug effects
Forced Expiratory Volume / drug effects
Heart Rate / drug effects
Humans
Ipratropium / administration & dosage,  pharmacology*
Male
Middle Aged
Pulmonary Disease, Chronic Obstructive / physiopathology*
Scopolamine Derivatives / administration & dosage,  pharmacology*
Smoking / pathology
Chemical
Reg. No./Substance:
0/Bronchodilator Agents; 0/Scopolamine Derivatives; 136310-93-5/tiotropium; 18559-94-9/Albuterol; 60205-81-4/Ipratropium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Sphingolipid biosynthesis is required for polar growth in the dimorphic phytopathogen Ustilago maydi...
Next Document:  Determination of relative protein degradation activity at different life stages in rainbow trout (On...