Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C1323099 (sympathomimetic)
 2,957 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

40 outpatients with chronic obstructive airway disease received the parasympatholytic bronchodilator ipratropium bromide (Sch 1000) and the sympathomimetic bronchodilator fenoterol from a metered dose inhaler. After evaluation of the initial values, first Sch 1000 was administered and 20 min. later airway resistance was measured, then fenoterol was given and a measurement was taken again 20 min. later. On the following day the aerosol inhalants were given in the reverse sequence. After the first inhalation 0.08 mg Sch 1000 proved to be an equally strong bronchodilator as 0.4 mg fenoterol and airway resistance was decreased to 52% and 55%, respectively of the initial value (p less than 0.001). The additional inhalation of the other bronchodilator caused a further slight decrease in airway resistance to a minimum of 47%, but was statistically significant (p less than 0.001) only in the case of the fenoterol/Sch 1000 sequence. The importance of bronchiolar tonus in regard to fluctuation of airway resistance and the possibility of a specific additive bronchodilatory effect of adrenergics and vagolytics is discussed.
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PMID:[Combined administration of ipratropium bromide (sch 1000) and fenoterol in patients with chronic obstructive airway disease (author's transl)]. 13 15

Two series of tests were carried out with 0.5 milligrams of fenoterol, 0.25 milligrams of ipratropium bromide (both by inhalation) and with 240 milligrams of theophylline (intravenously) in persons with extrinsic bronchial asthma. In the first series (A) the broncholytic effects of the drugs were studied by administering them after inhalation provocation tests. In series B the protective effects of the drugs were studied by giving them before the tests. Untreated probands served as controls; in series B 20 milligrams of disodium cromoglicicum were given in addition. The results in series A showed that fenoterol had significantly higher bronchospasmolytic efficacy than the other drugs which were only slightly effective. In series B, however, all four drugs had an equally potent protective action. The results indicate that regular administration of these agents benefits persons with allergic bronchial asthma whereas in acute asthmatic attacks prompt and adequate bronchospasmolysis can be induced only by sympathomimetic drugs with beta-effects.
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PMID:[The bronchospasmolytic and protective effects of fenoterol, ipratropium bromide, theophylline ethylenediamine and disodium cromoglicicum in inhalation challenge tests; a comparative study (author's transl)]. 15 16

Effects of carbachol, dbcGMP and 8-bromo-cyclic GMP on the positive inotropic actions of sympathomimetic amines and dbcAMP were studied on the canine isolated right ventricular myocardium. Carbachol alone did not substantially change the developed tension of the muscle, but did markedly shift the dose response curve for isoprenaline on the developed tension to the right and depressed the maximal response to the drug in a concentration dependent manner. The positive inotropic action of phenylephrine was affected by carbachol in the same manner as that of isoprenaline. DbcGMP in concentrations of 10(-3) M and higher produced a significant increase in the developed tension. The positive inotropic action of dbcGMP was partly inhibited by a beta-adrenoceptor blocking agent, pindolol. In the presence of dbcGMP, isoprenaline produced an action similar to that seen in the control experiment, but this action was not maintained on such a steady state level as in the control. This rapid decline of the effect of isoprenaline in the presence of dbcGMP was prevented by adding ascorbic acid to the organ bath. The positive inotropic actions of phenylephrine and of dbcAMP were not substantially affected by dbcGMP. 8-Bromo-cyclic GMP in a concentration of 10(-4) M did not change either the basal developed tension or the positive inotropic actions of noradrenaline and of isoprenaline. The present results indicate that these cyclic GMP derivatives are not able to mimic the antagonistic action of cholinergic stimulation on the positive inotropic action of adrenergic stimulation on the positive inotropic action of adrenergic stimulation on the canine ventricular myocardium.
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PMID:Failure of dibutyryl and 8-bromo-cyclic GMP to mimic the antagonistic action of carbachol on the positive inotropic effects of sympathomimetic amines in the canine isolated ventricular myocardium. 23 1

1. The effects of pancuronium bromide on the cardiovascular system of the pithed rat were examined. Pancuronium had two effects, a short-lasting cardiovascular stimulation following injection and a longer-lasting potentiation of responses to sympathetic nerve stimulation. 2 The initial effect of pancuronium was compared with that of tyramine. The cardioaccelerator but not the pressor responses to both pancuronium and tyramine were significantly reduced following sympathectomy with 6-hydroxydopamine (6-OHDA). 3 The action of pancuronium in potentiating sympathetic nerve responses was compared with that of known blockers of the neuronal uptake of noradrenaline (NA). Pancuronium (1 mg/kg) and cocaine (0.5 mg/kg) potentiated cardioaccelerator and pressor responses to sympathetic stimulation. These effects of pancuronium could be obtained following adrenalectomy and during neuromuscular blockade with gallamine. Pancuronium and uptake blockers potentiated the cardioaccelerator response to NA, reduced the response to tyramine, but did not affect the response to isoprenaline. Pancuronium and uptake blockers potentiated the pressor response to NA, but did not affect the response to tyramine or clonidine. 4 Following sympathectomy with 6-OHDA, pancuronium failed to potentiate cardioaccelerator and pressor responses to NA. 5 These results are discussed in relation to two main cardiovascular effects of pancuronium; an indirect sympathomimetic action and blockade of the neuronal uptake of NA.
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PMID:Sympathomimetic effects of pancuronium bromide on the cardiovascular system of the pithed rat: a comparison with the effects of drugs blocking the neuronal uptake of noradrenaline. 72 86

Anticholinergics (in particular, ipratropium bromide [Atrovent]) are first-line therapy in patients with chronic obstructive pulmonary disease (COPD). Although more studies are needed to support the use of combination therapy, adding an inhaled beta agonist to the therapeutic regimen is reasonable in patients who remain symptomatic and need quick relief. Patients frequently receive inadequate amounts of drug with standard doses delivered by metered-dose inhalers, often as the result of improper technique, so symptomatic patients may require higher doses. Caution is recommended when the dose of inhaled sympathomimetics is increased in COPD patients with ischemic heart disease or tachyarrhythmias. The addition of an oral sympathomimetic is seldom necessary. Theophylline may be considered in outpatients who remain symptomatic despite their use of inhaled bronchodilators, but heart disease, seizure disorders, and gastroesophageal reflux are contraindications. Corticosteroid therapy remains controversial but can be helpful in patients who still have severe disease despite maximum bronchodilator therapy. Antibiotics can be of benefit in COPD patients undergoing an exacerbation who have increasing dyspnea, cough, and phlegm production.
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PMID:Drug treatment of COPD. Controversies about agents and how to deliver them. 134 54

A double-blind, cross over, placebo controlled study was conducted to compare the response of lung function to metered doses inhaler of ipratropium bromide (IB, 40 micrograms, fenoterol hydrobromide (F), 100 micrograms, and a combination of the two (IBF). The drugs were administered on 4 consecutive days to 16 stable chronic airway obstructive patients (COPD), all of whom had shown minimal improvement after inhaling sympathomimetic drugs. Lung function response was measured for six hours after administration. All active medications caused greater improvement of FEV1 and FVC than the placebo did and none caused cardiovascular side effects. Improvement of FEV1 and FVC after IBF therapy was significantly better than after F at 1 hour and lasted up to six hour, whereas IBF was better than IB only after the third hour onwards. In addition, additive effects on FEV1 and FVC were seen in this period. IB caused greater response in FEV1 and FVC than F at both first and fifth hour. IB and IBF showed a rapid onset of action and had greater duration of action than F.
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PMID:The effects of inhaled ipratropium bromide, fenoterol and their combination in COPD patients. 214 Oct 57

The effects of nebulized solutions of ipratropium bromide and fenoterol combined were compared with the response to either preparation alone in single dose and longer-term administration in children who had asthma. The combination produced a slightly greater response than either alone, especially in peak expiratory flow. Over a 1-month period, there were no significant differences in symptom scores or lung function parameters between the combination of ipratropium bromide and fenoterol and fenoterol alone in a group of children who had asthma. It is possible that the addition of ipratropium bromide to a sympathomimetic drug may be useful in a subgroup of asthmatics, particularly if there is a considerable large airway contribution to bronchial narrowing.
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PMID:The effects of ipratropium bromide and fenoterol nebulizer solutions in children with asthma. 253 Oct 51

The effectiveness of nebulized anticholinergic and sympathomimetic regimens was evaluated in a double-blind study of 199 patients with acute airways obstruction. Patients were assigned to one of three treatment regimens according to a randomized schedule: 0.5 mg of ipratropium bromide, 1.25 mg of fenoterol hydrobromide, and 0.5 mg of ipratropium plus 1.25 mg of fenoterol. In 148 patients with acute exacerbations of asthma (mean one-second forced expiratory volume, 1.18 +/- 0.64 liters), all three regimens produced significant improvement in one-second forced expiratory volume (p less than 0.001). The greatest improvement followed treatment with the ipratropium-fenoterol combination (0.53 +/- 0.40 liters at 45 minutes; 0.57 +/- 0.51 liters at 90 minutes) and was significantly greater than that following either ipratropium alone (p less than 0.001) or fenoterol alone (p less than 0.05). In 51 patients with acute exacerbations of chronic obstructive pulmonary disease (mean one-second forced expiratory volume, 0.67 +/- 0.29 liter), each regimen produced significant improvement in one-second forced expiratory volume at both 45 and 90 minutes (for all, p less than 0.05), but there was no significant difference among the three treatment regimens. It is concluded that, in patients with acute asthma, combination therapy with sympathomimetic and anticholinergic agents is more efficacious than either one alone. In patients with acute exacerbations of chronic obstructive pulmonary disease, although either sympathomimetic or anticholinergic therapy provides bronchodilatation, no further benefit could be demonstrated from combination therapy.
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PMID:Nebulized anticholinergic and sympathomimetic treatment of asthma and chronic obstructive airways disease in the emergency room. 287 58

Many studies have evaluated the efficacy of ipratropium bromide in chronic obstructive pulmonary disease (COPD). Single-agent studies have shown ipratropium to be both safe and effective in COPD. Several studies have compared ipratropium with sympathomimetic agents or methylxanthines in patients with chronic bronchitis or emphysema; all of these studies have shown at least an equal, and in most instances a superior, bronchodilator action with ipratropium in terms of duration of action as well as peak bronchodilator effect in patients with COPD. In some patients with COPD, beta agonists, theophylline, or corticosteroids may have some additive, but not synergistic, bronchodilator effects when given with ipratropium.
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PMID:Ipratropium bromide in chronic bronchitis/emphysema. A review of the literature. 294 64

The chemistry, pharmacology, pharmacokinetics, clinical efficacy, adverse effects, and dosage of ipratropium bromide are reviewed. Ipratropium bromide, a synthetic quaternary isopropyl derivative of atropine, interrupts vagally mediated bronchoconstriction by inhibiting the cyclic guanosine 3',5'-monophosphate system at parasympathetic nerve endings. Ipratropium bromide is poorly absorbed after oral and inhaled administration but diffuses rapidly into tissue after i.v. or i.m. administration. The elimination half-life is 3.2-3.8 hours. After inhalation, the drug is eliminated in the urine and feces. The bronchodilatory effect of ipratropium bromide in stable chronic obstructive pulmonary disease appears to be comparable, and may be superior, to that of the beta-sympathomimetic agents. In acute exacerbations, ipratropium bromide is useful but may not be the preferred agent because of a delayed onset of action (within 15 minutes; mean dose-dependent duration of effect, three to five hours). Combination therapy with other bronchodilating drugs has proved useful. Ipratropium bromide may be a useful adjunctive agent in the treatment of asthma. Since the onset of action is delayed, ipratropium bromide should not be used as single-drug therapy in an acute asthmatic exacerbation. Reported adverse effects, including cough, nausea, palpitations, dry mouth, nervousness, gastrointestinal distress, and dizziness, have been mild. The usual dosage is two inhalations (36 micrograms) four times daily, and the maximum number of doses per day should not exceed 12. Although ipratropium bromide is currently indicated only for maintenance therapy in stable chronic bronchitis and emphysema, it may be useful as adjunctive therapy in asthma and in the management of acute exacerbations of chronic bronchitis and asthma. Additional experience in a variety of chronic obstructive pulmonary disorders will help to clarify the role of ipratropium bromide in the treatment of obstructive pulmonary disease.
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PMID:Use of ipratropium bromide in obstructive lung disease. 297 9


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