Ipratropium in patients with COPD receiving cholinesterase inhibitors.
Three patients with chronic obstructive lung disease (COPD) and myasthenia gravis whose pulmonary symptoms were worsened by therapy with cholinesterase inhibitors were improved by inhaled ipratropium bromide. Two had increases in FEV1 (19 percent, 35 percent) and specific conductance (106 percent, 81 percent) and reductions in dyspnea. The third had no change in airflow with ipratropium, but improved due to decreased bronchial secretions which had limited the use of cholinesterase inhibitors. In contrast, beta agonist bronchodilators had no effect in any of these patients. This experience suggests that ipratropium may be the bronchodilator drug of choice in patients with obstructive lung disease aggravated by cholinesterase inhibitors.
Liggett
S B
SB
Respiratory Division Jewish Hospital, Washington University Medical Center, St. Louis.
Daughaday
C C
CC
Senior
R M
RM
D000280:Administration, Inhalation; D000368:Aged; D001286:Atropine Derivatives / Q000627:therapeutic use*; D002800:Cholinesterase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D009241:Ipratropium / Q000627:therapeutic use*; D008173:Lung Diseases, Obstructive / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000150:complications / Q000188:drug therapy*; D011729:Pyridostigmine Bromide / Q000009:adverse effects / Q000627:therapeutic use
D001286:Atropine Derivatives; D002800:Cholinesterase Inhibitors; D009241:Ipratropium; D011729:Pyridostigmine Bromide