Changes in pulmonary function and cross-sectional area of trachea and bronchi in asthmatics following inhalation of procaterol hydrochloride and ipratropium bromide.
To determine the sites of action of inhaled adrenergic and anticholinergic bronchodilators, we used the acoustic reflection technique to measure airway area before and after administration of beta 2-selective adrenoreceptor agonist (procaterol hydrochloride) and quaternary anticholinergic agent (ipratropium bromide). Eight stable individuals with asthma (five men and three women; mean age, 34 +/- 12.7 yr) were studied on 2 days in single-blind randomized crossover fashion when they self-administered (using metered-dose inhaler) two puffs of either procaterol hydrochloride hemihydrate (10 micrograms/puff) or ipratropium bromide (20 micrograms/puff). Maximal expiratory flow-volume curve, specific airway resistance, and cross-sectional areas of three airway segments (extrathoracic tracheal, intrathoracic tracheal, and bronchial) were recorded at baseline and 15, 30, 60, and 120 min after drug administration. Both agents produced significant improvements in FEV1, FVC and forced expiratory flow at 50% of vital capacity (V50), and specific airway resistance (SRaw) as early as 15 min after drug administration. These effects were sustained for the 120 min monitoring period. However, all improvements were significantly greater for procaterol than for ipratropium. By contrast, there was no significant difference between drugs in the increased production in the cross-sectional areas of the three airway segments although there was a nonsignificant trend toward greater increases in tracheal area produced by the anticholinergic agent.(ABSTRACT TRUNCATED AT 250 WORDS)
Hoffstein
V
V
Department of Medicine, St. Michael's Hospital, Toronto, Canada.
Zamel
N
N
McClean
P
P
Chapman
K R
KR
D000162:Acoustics; D000280:Administration, Inhalation; D000328:Adult; D000403:Airway Resistance / Q000187:drug effects; D000704:Analysis of Variance; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology* / Q000503:physiopathology; D001980:Bronchi / Q000187:drug effects* / Q000473:pathology; D005260:Female; D006801:Humans; D009241:Ipratropium / Q000494:pharmacology / Q000627:therapeutic use*; D008176:Lung Volume Measurements; D008297:Male; D008449:Maximal Expiratory Flow-Volume Curves / Q000187:drug effects; D008875:Middle Aged; D017265:Procaterol / Q000494:pharmacology / Q000627:therapeutic use*; D016037:Single-Blind Method; D014132:Trachea / Q000187:drug effects* / Q000473:pathology
D009241:Ipratropium; D017265:Procaterol