Common cold and high-dose ipratropium bromide: use of anticholinergic medication as an indicator of reflex-mediated hypersecretion.
It was our aim to study the role played by parasympathetic reflexes for the amount and physical characteristics of nasal discharge during a common cold, and to define the maximum anti-rhinorrhoea effect obtainable with anticholinergic medication. Fifty adults with naturally acquired colds were treated with a very high dose of the topically active cholinoceptor-antagonists ipratropium bromide in a randomized, double-blind, placebo-controlled study of parallel groups. A dosage of 400 micrograms was given 4 times daily for 3 days, using a specially manufactured high-dosed pressurized aerosol. This treatment resulted in a 56% reduction in the number of nose blowings (p < 0.01) and a 58% reduction in the weight of blown secretions (p < 0.01). Assessment of the "pourability" of the nasal discharge indicated that ipratropium bromide mainly reduces the watery secretions but not the mucopurulent secretions. The high dose of ipratropium bromide caused nose- and mouth-dryness in a considerable number of the patients.


CONCLUSIONS
(1) during the first days of a common cold about 60% of the nasal discharge is a reflex-mediated product from nasal glands; (2) this type of secretion is predominantly watery; and (3) ipratropium bromide can reduce watery rhinorrhoea in the common cold, but a lower dose is required in order to avoid side effects.
Ostberg
B
B
Department of Otorhinolaryngology, Rigshospitalet, Copenhagen, Denmark.
Winther
B
B
Borum
P
P
Mygind
N
N
D000280:Administration, Inhalation; D000328:Adult; D000336:Aerosols; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D009241:Ipratropium / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000378:metabolism; D010275:Parasympathetic Nervous System / Q000503:physiopathology; D010276:Parasympatholytics / Q000008:administration & dosage / Q000627:therapeutic use*; D012223:Rhinitis, Vasomotor / Q000188:drug therapy* / Q000503:physiopathology; D018709:Statistics, Nonparametric
D000336:Aerosols; D010276:Parasympatholytics; D009241:Ipratropium