title: Combined treatment with acetazolamide and medroxyprogesterone in chronic obstructive pulmonary disease patients.
abstract: Medroxyprogesterone acetate (MPA) and acetazolamide (ACET) are two ventilatory stimulants which are used in hypoxic and hypercapnic patients with chronic obstructive pulmonary disease (COPD). In a double-blind randomised study, the effects of a 2-week treatment with MPA (30 mg b.i.d.) or ACET (250 mg b.i.d.), followed by a 2-week treatment with a combination of both drugs (MPA/ACET), on daytime and nocturnal ventilatory and blood gas parameters in 17 stable hypercapnic COPD patients were investigated. ACET, MPA and MPA/ACET treatment decreased mean daytime carbon dioxide tension in arterial blood by 0.4, 0.7 and 1.2 kPa, respectively. Minute ventilation was improved only with combined therapy, from 9.3 to 11.2 L x min(-1). With MPA/ACET therapy, the hypercapnic and hypoxic ventilatory responses significantly increased, from 3.7 to 5.8 L x min(-1) x kPa(-1) and from -0.13 to -0.40 L x min(-1) x %(-1), respectively. The mouth exclusion pressure response to hypoxia increased during combination therapy, from -0.01 to -0.03 kPa %(-1). Nocturnal end-tidal carbon dioxide tension decreased with MPA and MPA/ACET treatment, by 0.9 and 1.4 kPa, respectively. MPA/ACET significantly increased mean nocturnal arterial oxygen saturation values, from 85.5 to 90.2%. The authors conclude that short-term combined treatment with medroxyprogesterone acetate and acetazolamide has a more favourable effect on day and night-time blood gas values and chemical drive than single drug treatment.
authors.affiliation: Dept of Pulmonary Diseases, Dekkerswald University of Nijmegen, Nijmegen, The Netherlands. m.wagenaar@ulc.azn.nl
authors.forename: M
authors.initials: M
authors.lastname: Wagenaar
authors.forename: P Je
authors.initials: PJ
authors.lastname: Vos
authors.forename: Y F
authors.initials: YF
authors.lastname: Heijdra
authors.forename: L J
authors.initials: LJ
authors.lastname: Teppema
authors.forename: H T M
authors.initials: HT
authors.lastname: Folgering
mesh_terms: D000086:Acetazolamide / Q000008:administration & dosage*; D000368:Aged; D002245:Carbon Dioxide / Q000097:blood; D002257:Carbonic Anhydrase Inhibitors / Q000008:administration & dosage*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D006801:Humans; D006935:Hypercapnia / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D000860:Hypoxia / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D008525:Medroxyprogesterone / Q000008:administration & dosage*; D010100:Oxygen / Q000097:blood; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D012119:Respiration / Q000187:drug effects
chemical_list: D002257:Carbonic Anhydrase Inhibitors; D002245:Carbon Dioxide; D008525:Medroxyprogesterone; D000086:Acetazolamide; D010100:Oxygen