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Query: UMLS:C1323099 (sympathomimetic)
 2,957 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nine papers which have specifically examined the effects of combining sympathomimetic bronchodilator therapy with ipratropium bromide in the treatment of patients with airflow obstruction are reviewed. The published evidence suggests that the use of combination therapy in the more elderly bronchitic patients is now justified, but that the case for routinely giving such treatment to younger asthmatic patients needs further evaluation before any definite recommendation can be made.
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PMID:Combination therapy--a review of clinical studies. 614 52

Human lung tissue passively sensitized with anti-grass pollen IgE antibodies releases histamine upon exposure to specific grass pollen antigen. Beta-sympathomimetic agents inhibit the antigen-induced release of histamine, thus beta-sympathomimetic drugs might exhibit a combination of prophylactic and direct bronchodilating properties in the treatment of allergic bronchial asthma. The anticholinergic agent ipratropium bromide had no direct effect on the immunologically induced release of histamine. Acetylcholine increased the antigen-induced release of histamine significantly. This enhanced release was almost completely inhibited by ipratropium bromide as a result of competitive inhibition. This mode of action may add to the usefulness of anticholinergic agents in vagus-controlled chronic obstructive ventilatory disorders.
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PMID:Anti-allergic effect of beta-2 agonists and cholinoceptor antagonists in vitro. 619 94

1. Bronchodilatation was produced in eight normal subjects by inhalation, on separate occasions, of the atropine-like drug ipratropium bromide (0.16 mg by pressurized inhaler; 1 mg nebulized) and the beta 2-sympathomimetic salbutamol (0.8 mg by pressurized inhaler; 5 mg nebulized). 2. Mean specific airways conductance (sGaw) increased from a mean value of 0.185 +/- SE 0.002 to 0.292 +/- 0.023 s-1 kPa-1 after ipratropium bromide, and from 0.184 +/- 0.020 to 0.303 +/- 0.026 s-1 kPa-1 after salbutamol. These increases in sGaw were not significantly different from each other. 3. During both maximal and partial expiratory flow volume manoeuvres similar increases in flow rates were produced by each drug, at all lung volumes, from 40 to 20% of vital capacity. 4. Changes in maximal and partial flow volume curves after washout of lung air with helium/oxygen (4:1) were measured before and after each drug. Flow rates increased in all subjects and the percentage increase in maximum flow when helium was breathed was not significantly different, when repeated after each drug. 5. Thus our results suggest that salbutamol and ipratropium have similar sites of action, both affecting both large and small airways, and produce similar degrees of bronchodilatation. This is supported by our results after the helium/oxygen breathing, where the lack of change in density dependence of maximal flow suggests that there was no change in the distribution of airways resistance after the drugs.
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PMID:Effects of inhalation of beta-sympathomimetic and atropine-like drugs on airway calibre in normal subjects. 621 27

After application of ipratropium bromide (Itrop) a long-time increase of frequency and left ventricular ejection time can be observed. Beside a vagolytic effect a sympathomimetic action of the drug could be demonstrated by experimental investigations. In 10 patients hemodynamics in comparison to arteficial atrial pacing and after parenteral administration of 0.5 mg ipratropium bromide were investigated. The intervention by the drug led to an increase of heart rate from 54 to 93 beats/min. Cardiac index showed an increase from 2.40 to 2.96 l/min/m2, while stroke volume decreased from 82.0 to 59.1 ml. Compared to hemodynamic parameters measured under atrial pacing at the same heart rate no significant differences could be found. It could be demonstrated, that ipratropium bromide showed no positive inotropic effect of clinical relevance. The increase of cardiac index is referred to an augmented cardiac output due to a rise of heart rate.
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PMID:[Hemodynamic effects of ipratropium bromide in comparison with atrial stimulation]. 622 95

The tone of bronchial muscle depends on the balance between the activity of the parasympathetic and sympathetic divisions of the autonomic nervous system. It is possible to produce broncho-dilatation either by stimulating the sympathetic pathway with sympathomimetic agents such as fenoterol or inhibiting the action of the parasympathetic system using anti-cholinergic agents such as ipratropium bromide.
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PMID:The background to Duovent. 623 45

IK-6, a combination of the sympathomimetic fenoterol (low dose) and the anticholinergic ipratropium bromide (normal dose), was tested single-blind and cross-over in outpatients with intrinsic asthma and in healthy volunteers. In 12 patients IK-6 resulted in a good acute bronchodilatation, the onset was as quick as following fenoterol and the maximum was as good as following ipratropium bromide. In another 12 patients the protective effect against an acetylcholine-induced bronchoconstriction was better after IK-6 than after ipratropium bromide and much better than after salbutamol. In these patients IK-6 caused no unwanted side effects. In 10 healthy volunteers the effect on heart rate was tested after inhalation of 20 puffs of bronchodilators applied by metered dose inhaler. The anticholinergics (ipratropium bromide, oxitropium bromide, dibenzothiepine-derivative) caused no effect. Following fenoterol a marked increase in heart rate could be observed, whereas the combination IK-6 caused only a slight increase.
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PMID:[Clinical pharmacological trials of a new metered dose inhaler, IK-6, a combination of the bronchodilators fenoterol and ipratropium bromide (author's transl)]. 644 83

This study has compared the short-term bronchodilator effects of inhaled anticholinergic (ipratropium bromide) and sympathomimetic (fenoterol) agents alone and in combination in 18 asthmatic patients. the study was of double-blind, placebo-controlled, crossover design. The combination of 60 micrograms ipratropium bromide and 200 micrograms of fenoterol had a greater bronchodilator effect than lower dose combinations or either drug alone. Small but significant gains may be made with combination inhaled bronchodilator therapy.
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PMID:Combination bronchodilator therapy in asthma. 645 57

We studied 25 adolescent and adult patients with cystic fibrosis (CF) and 25 control subjects to determine if the prevalence of atopy and bronchial hyperreactivity was increased in this disease. Results showed that atopic symptoms, as defined by history, were more frequently present in the CF patients. Prick testing of the skin produced positive reactions in 88% of the CF group and 36% of the control subjects (p less than 0.001), and the mean number of reactions per subject was significantly higher in the former group (p less than 0.001); reactions to fungal antigens were strikingly positive in the CF group. The CF patients had a significantly higher mean serum IgG4 (p less than 0.001), IgE (p less than 0.01), and higher mean eosinophil count (p less than 0.05). Clear-cut bronchial hyperreactivity was demonstrated in the CF group compared with control subjects. Bronchial provocation with 400 micrograms of histamine led to a greater than 15% fall in the preinhalation FEV1 in 35% of the CF subjects compared with 4% of the control group, with a mean percentage fall of 15% and 3% respectively (p less than 0.001). In the CF group a greater than 15% rise in PEFR occurred in 32% after inhalation of the parasympatholytic, ipratropium bromide (54 micrograms), and in 27% after inhalation of the sympathomimetic, fenoterol (400 micrograms). No correlation was found between bronchial reactivity and atopic status, HLA phenotype pattern, or disease severity. The cause of the increased prevalence of atopy and bronchial reactivity in CF patients remains unknown. However, it is clear that a trial of bronchodilator therapy is warranted in adolescents and young adults with CF.
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PMID:Atopy and bronchial reactivity in older patients with cystic fibrosis. 722 75

Ipratropium bromide is a synthetic derivative of atropine with little absorption when used in inhalation, and therefore little secondary effects. The authors review its pharmacological properties and therapeutic efficacy in the treatment of asthma in children. Combined nebulized inhalation of ipratropium bromide and beta 2 sympathomimetic results in a more efficient and more sustained bronchodilatation than beta 2 sympathicomimetic alone in the treatment of acute asthma in children. Ipratropium bromide should be usefully introduced in the therapeutic scheme of acute asthma in children. Further studies will be necessary in order to determine its efficacy and tolerance in infants.
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PMID:[Value of ipratropium bromide in asthma crisis in children]. 808 27

There is no lack of data in the literature reporting on the efficacy of different bronchodilators. However, the discussion concerning the superiority of one bronchodilator over another in patients with chronic bronchitis and airflow obstruction is, and remains, a controversial subject. This has been particularly so since the perfection of synthetic anticholinergics delivered by inhalation without any side-effects. The aim of the present work is to compare the bronchodilator effects of a sympathomimetic, fenoterol (Berotec), and of an anticholinergic, ipratropium bromide (Atrovent), compared to a placebo in twelve unselected chronic bronchitics who had airflow obstruction and were in a stable clinical state. The bronchodilator effect of the two drugs was judged at the same time by variations on forced expired volume (FEV1) which was taken as a reference value, and of the maximum mid-expiratory flow (MEF) measured by spirography and also the variations of pulmonary resistance (delta Rrs) measured by the forced oscillatory method. The comparison of these indices enables the site of action of these agents to be specified. The dose response curve and the duration of action over six hours was assessed for each of the three agents. These were administered in succession and at random over three days by inhalation using an inhalation chamber. All the patients who were included were capable of producing a bronchodilator response but two of them responded only to one agent. The change in the FEV1 was comparable with the two active products. The change in MEF (an index of peripheral airways) was significantly greater following ipratropium.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Comparison of bronchodilator effects and site of action of fenoterol and ipratropium in chronic obstructive bronchitis]. 845 2


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