title: Comparison of nebulized glycopyrrolate and metaproterenol in chronic obstructive pulmonary disease.
abstract: We assessed the bronchodilating effect of glycopyrrolate (GP) and compared it with that of metaproterenol (MP), alone and in combination (GP+MP), in patients with chronic obstructive pulmonary disease (COPD). In a double-blind study, 11 patients (aged (mean +/- SD) 69 +/- 6 yrs; forced expiratory volume in one second (FEV1) 1.2 +/- 0.4 L) with stable COPD inhaled nebulized GP 1.0 mg, MP 15 mg, or GP 1.0 mg+MP 15 mg. Spirometry was performed before inhalation and at hourly intervals for 8 h after inhalation. It was found that GP produced a bronchodilating effect that was about equal to that of MP but lasted longer (8 vs 5 h). The combination of GP and MP produced a bronchodilating effect that was greater than that of either drug alone and was evident mostly during the effect of MP. The mean peak percentage improvement in FEV1 over baseline was 35% for GP+MP and 25% for either drug alone. These data suggest that nebulized glycopyrrolate is an effective bronchodilator in some patients with chronic obstructive pulmonary disease. Concurrent administration of glycopyrrolate and metaproterenol produces additional bronchodilation that is primarily apparent during the bronchodilator effect of metaproterenol.
authors.affiliation: Dept of Medicine, Finch University of Health Sciences, Chicago, IL, USA.
authors.forename: G
authors.initials: G
authors.lastname: Tzelepis
authors.forename: S
authors.initials: S
authors.lastname: Komanapolli
authors.forename: D
authors.initials: D
authors.lastname: Tyler
authors.forename: D
authors.initials: D
authors.lastname: Vega
authors.forename: A
authors.initials: A
authors.lastname: Fulambarker
mesh_terms: D000280:Administration, Inhalation; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D001991:Bronchitis / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D004338:Drug Combinations; D004347:Drug Interactions; D005541:Forced Expiratory Volume / Q000187:drug effects; D006024:Glycopyrrolate / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009921:Metaproterenol / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D011656:Pulmonary Emphysema / Q000188:drug therapy*
chemical_list: D000318:Adrenergic beta-Agonists; D001993:Bronchodilator Agents; D004338:Drug Combinations; D018727:Muscarinic Antagonists; D009921:Metaproterenol; D006024:Glycopyrrolate