Nebulised salbutamol with and without ipratropium bromide in acute airflow obstruction.
103 patients with acute airflow obstruction (56 asthma, 47 chronic obstructive pulmonary disease [COPD]) completed a double-blind trial of nebulised bronchodilator treatment in a hospital accident and emergency department. Each patient was randomised to receive either 10 mg of salbutamol nebuliser solution in 2 ml of saline or 10 mg of salbutamol in 2 ml (0.5 mg) of preservative-free ipratropium bromide. Peak flow rate (PFR) was recorded before treatment and 1 hour after beginning nebulised treatment. In 23 asthmatic patients given salbutamol alone PFR rose by a mean 31% 1 hour after treatment whereas in 33 such patients given combined treatment it rose by a mean 77% (95% confidence interval for the difference 8-84%). Patients whose PFR was below 140 l/min at entry gained maximum benefit from the combined treatment. For COPD patients the PFR rise was almost identical for both treatments. In acute asthma the immediate PFR response to a mixture of salbutamol and ipratropium bromide was better than the response to nebulised salbutamol alone. For COPD patients, the two treatments were of equal benefit.
O'Driscoll
B R
BR
Hope Hospital, Salford.
Taylor
R J
RJ
Horsley
M G
MG
Chambers
D K
DK
Bernstein
A
A
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000420:Albuterol / Q000008:administration & dosage* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001286:Atropine Derivatives / Q000008:administration & dosage*; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D006801:Humans; D009241:Ipratropium / Q000008:administration & dosage* / Q000627:therapeutic use; D008173:Lung Diseases, Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D010366:Peak Expiratory Flow Rate; D011897:Random Allocation
D001286:Atropine Derivatives; D009241:Ipratropium; D000420:Albuterol