[Effects of ipratropium bromide (IPB) and its combination with salbutamol sulfate (SAS) in acute asthmatic attack].
34 patients with acute asthmatic attack were studied in double-blind, randomized and crossover manner. Each of them was treated with following two protocols during two sequential days: 0.5 mg of ipratropium bromide (IPB), followed by 5 mg of salbutamol sulfate (SAS) 75 minutes later; or 5 mg of SAS, followed by another dose 35 minutes late. The drugs were delivered via a jet nebulizer. The effects and side-effects of the treatment were evaluated immediately before the first inhalation and at peak of bronchodilatation (60-75 minutes after IPB or 20-35 minutes after SAS). Compared with inhaled SAS, IPB produced considerable improvement in central airway parameters such as forced expiratory volume in one second (FEV1) peak expiratory flow (PEF) and respiratory resistance (Rrs) (P greater than 0.05), but less improvement in peripheral airway parameters such as forced vital capacity (FVC) and maximal mid-expiratory flow (MMEF) (P less than 0.01). The sequential inhaled SAS after IPB improved all five parameters (P less than 0.01), but the repeated dose of SAS increased only MMEF (P less than 0.01). Compared with double-dose SAS, the sequential treatment with IPB and SAS 1 ed to considerable improvement in FVC and MMEF (P greater than 0.05), but greater improvement in FEV1, PEF and Rrs (P less than 0.01). Heart (rate and tremor scores after two doses of SAS increased significantly (P less than 0.01). It is concluded that IPB alone is less effective than beta-adrenoceptor agonist, but its combination with SAS would be an effective and safe treatment in acute asthmatic attack.
Chen
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Deng
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Ye
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D000328:Adult; D000420:Albuterol / Q000008:administration & dosage* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001286:Atropine Derivatives / Q000008:administration & dosage*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D009241:Ipratropium / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests
D001286:Atropine Derivatives; D009241:Ipratropium; D000420:Albuterol