Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effect of ipratropium (Atrovent) 0.125 mg x 4 daily was compared to terbutalin (Bricanyl) 5 mg x 4 daily, given to 19 patients with chronic obstructive airways disease (15 with chronic bronchitis, 10 bronchial asthma, 7 pulmonary emphysema) as inhalation therapy with Monaghan IPPB-M 515, during 2 treatment periods of 3 days. The investigation was carried out as a controlled, double-blind, cross-over comparison. The effect of treatment was evaluated by measurement of PEFR, symptom scores, including the side-effects and the use of rimiterol MDI for the treatment of acute attacks. The PEFR values were all higher than the initial values (P less than 0.001) during the period of treatment (08.00-20,30 hrs). The highest values were recorded at 16.30 hrs, these were PEFR + 31.7% for the Atrovent period and PEFR + 28.0% for the Bricanyl period. No statistically significant difference was observed in the PEFR, symptom scores, side-effects and the use of rimiterol during the Atrovent and Bricanyl treatment periods. The authors suggest that Atrovent is a wellsuited alternative bronchodilatator, particularly for patients with tremor, muscle cramp, and "inner restlessness" following treatment with a beta 2-stimulator.
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PMID:A comparative study of the bronchodilatating effects of ipratropium and terbutalin inhaled with Monaghan IPPB-M 515 by 19 patients with chronic obstructive airways disease. 15 95

Terbutaline, a selective beta2-adrenergic receptor stimulator was given to 10 patients with chronic bronchitis. The effects of the drug were tested by measurements of forced expiratory volume in 1 sec (FEV1), peak expiratory flow rate (PEFR), heart rate, blood pressure and blood gas analysis. The measurements were performed before and 1, 2, 4, 5, and 6 h after oral administration of placebo, 2.5 mg, or 5.0 mg terbutaline. Terbutaline caused a significant dose-related increase in FEV1 and PEFR as compared with placebo. The maximal effects were found at the 4-h measurement and were still present at the measurements performed at 6 h. Heart rate, blood pressure and arterial oxygen tension (PaO2) were not significantly affected. Four patients experienced side effects as tremor and/or heart palpitations. It is concluded that orally administered terbutaline may be an important therapeutical agent in the treatment of chronic bronchitis.
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PMID:Effect of a single graded dose of terbutaline tablets in patients with chronic bronchitis and bronchoconstriction. A double-blind, placebo, cross-over study. 36 41

The association between diseases and symptoms and general hospital care was studied in a geographically defined population of 1040 persons aged 65 years or over (90% of the eligible non-institutionalized elderly). In eight years, 25% of the subjects used over 60 hospital bed-days. In age-controlled analyses high use of hospital care was predicted by chronic urinary infections and in women also by chronic bronchitis, diabetes mellitus and heart failure. Among men, the risk of high use of hospital care was greatest in those reporting chronic urinary infection (risk ratio 1.9), and among women in those reporting chronic bronchitis (2.1) and diabetes (2.0). As far as symptoms were concerned, the highest risks of hospital care were found in men reporting tremor (risk ratio 1.6) and depressive symptoms (1.5); and in women reporting memory disturbances and dizziness (risk ratios 1.9 and 1.7, respectively). High use of care was predicted by six symptoms in men and seven in women. Reported symptoms proved to be better predictors of high use of hospital care than reported diagnoses.
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PMID:Diseases and symptoms as predictors of hospital care in an aged population. A prospective register-based study. 149 34

Higher doses of inhaled albuterol have been shown to cause slightly more bronchodilatation than standard doses from a metered-dose inhaler in patients with severe chronic airflow limitation. Higher doses, however, carry an increased risk of side effects, and the optimum dose balancing benefit and adverse effects have yet to be established. We have therefore looked at objective and subjective evidence of beneficial and adverse effects after 4 doses of albuterol in 30 patients with chronic bronchitis, severe airflow limitation, and less than 200 ml increase in FEV1 after 200 micrograms inhaled albuterol. Subjects were given placebo, 400 micrograms, 1 mg, 2 mg, and 4 mg albuterol by dry powder inhaler in random order on separate days in a double-blind study, and FEV1, relaxed VC, PEFR, 12-min walk distance, finger tremor, oxygen saturation, heart rate, and arrhythmias were measured at intervals over 6 h. With increasing doses of albuterol, there was a significant dose-related increase in FEV1, VC, and PEFR, the maximal mean changes being 196 ml, 480 ml, and 50 L/min, respectively. The duration of effect was longer with the higher doses. There was a dose-related increase in heart rate, tremor amplitude, and supraventricular ectopic beats and a dose-related fall in oxygen saturation. There was no drug-related effect on the frequency of ventricular ectopic beats either at rest or during the walk tests. The largest increases in walk distance occurred after the 1 and 2 mg doses and the least after the 4 mg dose.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:High-dose inhaled albuterol in severe chronic airflow limitation. 246 83

Beta 2-adrenergic agents are useful in the management of acute and chronic asthma. Chronic bronchitis and emphysema are less responsive to bronchodilator therapy; however, a trial of beta 2-agonists is warranted in search of a reversible component. The newer beta 2-sympathomimetic agents have no important differences in the quality of bronchodilation, but individual patients may respond more favorably to one drug than to another. Most of the common adverse effects (eg, tremor and tachycardia) are an extension of the pharmacologic effects, so there are no important differences at equipotent doses. When chronic symptoms necessitate maintenance treatment, the frequency of dosing may become a deciding factor in the selection of a bronchodilator. Since tulobuterol is recommended for twice-a-day dosing, it may be more convenient for the patient than beta 2-sympathomimetics that require more frequent administration. The prolonged duration of action of tulobuterol minimizes the need for nocturnal drug administration, allowing the patient to sleep through the night. Thus tulobuterol offers the benefits of extended symptomatic protection and improved patient compliance.
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PMID:Tulobuterol in the management of obstructive airways disease in adults. 286 99

The dose response profiles of Duovent (fenoterol 0.1 mg/ipratropium 0.04 mg per puff) and salbutamol (0.1 mg per puff) were determined in a double-blind, controlled study. Twenty-one patients with asthma and nine patients with chronic bronchitis received 1, 2, 4, and 6 puffs of either Duovent or salbutamol on separate days. FEV1, pulse and tremor were recorded at baseline and up to 360 minutes after inhalation of test medication. Duovent and salbutamol produced an effective bronchodilator response at all dose levels, however, at 2, 4 and 6 puffs, the improvement with Duovent was significantly greater than with salbutamol alone in both asthmatic and chronic bronchitic patients. Two puffs of Duovent produced a significantly greater bronchodilation than all doses of salbutamol. There was no difference in the bronchodilator response between 1-6 puffs of salbutamol indicating maximal dose was achieved with one puff. There was an incremental improvement in FEV1 with 1, 2, and 4 puffs of Duovent but no difference between 4 and 6 puffs. There was no difference in pulse rate or tremor between salbutamol or Duovent at any dose level. We conclude that Duovent produces a greater and more prolonged bronchodilator response than salbutamol in both asthmatic and chronic bronchitic patients.
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PMID:A dose response study comparing Duovent vs salbutamol. 296 36

Ten patients with chronic bronchitis (Medical Research Council definition) completed a double-blind placebo-controlled study comparing 400 micrograms, 1 mg, 1.6 mg and 2 mg salbutamol powder. Response was measured by spirometry, peak expiratory flow rate, heart rate and tremor at intervals up to 4 hours post-inhalation. Pulmonary function results showed a trend towards higher doses producing improved response and a longer duration of action, with bronchodilatation following 2 mg significantly greater than 400 micrograms. Seven patients developed or had an increase in tremor following a single dose of 2 mg and in one this was considered to be severe. No adverse effects were recorded on ECG.
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PMID:High dose salbutamol in chronic bronchitis: comparison of 400 micrograms, 1 mg, 1.6 mg, 2 mg and placebo delivered by Rotahaler. 331 Nov 17

The effects of inhaling an aerosol preparation containing fenoterol 200 micrograms and ipratropium bromide 80 micrograms were compared with those of inhaling 200 micrograms of salbutamol and a similar dose of fenoterol on 20 patients with chronic bronchitis and four patients with chronic stable asthma. The dose of each drug was contained in 2 puffs taken from a metered-dose inhaler. Changes in airways function were assessed by measuring peak expiratory flow rate. Pulse, blood pressure and presence of any tremor were monitored to detect drug-induced side effects. No significant difference was found in the onset of action and overall bronchodilator effects between the three drugs. The combined preparation was found to have a significantly greater bronchodilator action three and four hours after inhalation compared to the other two drugs. A significant effect lasting six hours was found with salbutamol and fenoterol, but the combined preparation had an effect which was significant up to seven hours. There was no significant difference in the side effects which were minimal for all three drugs.
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PMID:A comparison of effects of inhaling a combined preparation of fenoterol with ipratropium bromide (Duovent) with those of fenoterol and salbutamol. 623 47

The anticholinergic, antimuscarinic compounds are potent and hitherto neglected bronchodilators. Although atropine itself has drawbacks, principally related to its rapid absorption and consequent systemic side effects, its quaternary ammonium congeners, atropine methonitrate and ipratropium bromide, are poorly absorbed. When given by inhalation, they are as effective bronchodilators as atropine is, but longer acting and much less prone to side effects. They act predominantly at a site that is different from adrenergic agents and thus afford an alternative, complementary approach to the treatment of airways obstruction. In stable asthmatic subjects, ipratropium is almost as potent a bronchodilator as beta 2-adrenergic agents are. In patients with chronic bronchitis and emphysema, it is more potent than beta 2-adrenergic agents are. In both conditions, its combination with other bronchodilators adds significantly to the level and duration of bronchodilatation. It may also be occasionally useful in counteracting bronchospasm caused by specific stimuli, such as cold air and exercise, and particularly that caused by inadvertent beta-adrenergic blockade. By inhalation, ipratropium is relatively free of side effects, even in doses as much as 20 times those that produce maximal bronchodilatation. It does not significantly affect mucus production, viscosity, or clearance, problems for which atropine is suspect. Nor does it produce tremor and tachycardia, as do adrenergic agents. It can also probably be safely used in patients with glaucoma and bladder neck obstruction, unlike atropine. Ipratropium will probably find its major application in the long-term management of chronic bronchitis and emphysema, and in asthmatic patients who are poorly controlled by, or who experience troublesome side effects from, adrenergic agents.
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PMID:Anticholinergic, antimuscarinic bronchodilators. 637 60

Twenty-one patients with chronic bronchitis and reversible airway obstruction participated in two single-blind, cross-over, placebo-controlled studies in inhaled clenbuterol - a new bronchodilator - and salbutamol. Nine patients participated in a dose-response study. Clenbuterol 10 microgram/puff, salbutamol 100 microgram/puff and placebo, were given by pressurized aerosol in cumulative doses of 1, 2, 4, 8, and 16 inhalations of each drug and placebo. The mean peak % FEV1 increases above the baseline were similar after all doses of clenbuterol and salbutamol and were significantly greater than after placebo. No cardiovascular effects were observed. Tremors were noted in two patients after 160 microgram clenbuterol and in one patient after 1600 microgram salbutamol. In a second study, clenbuterol (20 microgram), salbutamol (200 microgram) - two equieffective doses - and placebo were compared in a 6 h period in 12 patients. Clenbuterol and salbutamol produced bronchodilation of comparable magnitude, onset of action (15 min) and duration (4-6 h). Clenbuterol is an effective bronchodilator and, on the basis of molecular weight, about ten times more potent than salbutamol when given by aerosol.
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PMID:A comparison between inhaled clenbuterol and salbutamol in chronic bronchitis with reversible airway obstruction. 700 74


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