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Query: UNIPROT:Q99581 (FEV)
 3,296 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effects of (a) regular use for one week and (b) a single dose of a synthetic anticholinergic (ipratropium bromide) on lung mucociliary clearance and as a bronchodilator was ascertained in a controlled, double-blind, cross-over study in 12 patients with reversible airways obstruction (mean increase in FEV after isoprenaline: 17% range 10-50%). Two puffs from a metered dose inhaler of either placebo (propellants only) or drug (40 microgram) were administered four times a day for one week (regular use), and mucociliary clearance was measured, by radioaerosol tracer, at the end of each treatment period and after a control period in which no treatment was given. On the mornings of the measurements after the placebo and drug periods one final dose (single dose) of ipratropium (40 microgram) or placebo was given 2.5 hours before the start of the test. There was no statistically significant difference between the three mean mucociliary clearance curves (control, placebo, and drug) for the group; however, there was a significantly greater penetration towards the periphery of the lung of the tracer in the test after drug administration compared with the other two. This increased penetration was attributed to bronchodilatation caused by the drug. Ipratropium bromide does not appear to impair mucociliary clearance, and it acts an effective bronchodilator.
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PMID:Effect of ipratropium bromide on mucociliary clearance and pulmonary function in reversible airways obstruction. 15 10

The bronchodilator actions of salbutamol and ipratropium bromide were compared in 30 established cases of bronchial asthma, before and after exercise. It was noticed that after exercise (brisk walk for 3 min.) the PFT values of FVC, PEFR and FEV-1, decreased remarkably from the basal values, the mean fall of 17.91%, 10.68% & 14.8% respectively was noticed. Salbutamol showed improvement in FVC, PEFR, FEV-1, of 20.86%, 15.96% & 17.98% respectively from basal values, while Ipratropium bromide showed improvement by 18.31%, 13.01% & 20.90% respectively. It was also noted that salbutamol is a better drug amongst smokers, patients with family history of bronchial asthma, and in younger age groups. Ipratropium bromide was better in elderly patients (> 40 yrs.) and in those with eosinophillia.
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PMID:A comparative study of bronchodilator actions of ipratropium bromide (atrovent) & salbutamol (ventolin) on exercise induced bronchial asthma. 130 96

To investigate the mechanism of bronchial spasm induced by inhalation of ultrasonically nebulised distilled water (UNDW) ultrasonically nebulised solutions including hypoosmolar (distilled water, 0.3% NaCL) isoosmolar (0.9% NaCL) and hyperosmolar solutions (2.7% NaCL, 3.6% NaCL, 4.6% KCL 22.2% dextrose) were used for challenge test in 12 asthmatic patients and 10 healthy subjects as controls. The dose of solution required to induce a 20% reduction in FEV 1 (FD 20-FEV 1) was recorded. In another 10 asthmatic patients, a challenge with UNDW was conducted after pretreatment with sodium cromoglycate (SC), Ipratropine Bromide (IB) to investigate the protective effect of the two medicines. The results showed that distilled water and three hyperosmolar solutions which were of the same osmotic pressure (3.6% NaCL, 4.6% KCL and 22.2% dextrose) were most potent in inducing bronchoconstriction, and no significant difference in PD 20-FEV 1 was found among them 0.3% and 2.7% NaCL were next and 0.9% NaCL was the least potent. Normal subjects showed no response to the solutions. The SC gave significant protection to nine of the ten patients, and IB gave it to five of the ten. Our results indicate that a change in the osmolarity of the fluid lining the respiratory tract may be an important determinant of the airway response; sodium cromoglycate which inhibits the mediator release of mast cell can reduce the airway response to UNDW.
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PMID:[Effects of nebulized distilled water on tracheal reaction in asthmatic patients]. 253 83

Combinations of beta-stimulant and anticholinergic drugs have been advocated as a potentially useful tool in the treatment of reversible airway obstruction. We investigated the effectiveness and safety of a metered aerosol preparation delivering fenoterol 100 micrograms and ipratropium bromide 40 micrograms per puff: two dosages (2 puffs and 4 puffs) were used in 16 asthmatic patients, and their acute effects (up to 420 min) were investigated in a double-blind randomized trial. The results point out a reasonably good response to both dosages, with no notable difference between them as far as vital capacity, FEV 1, MMEF and Vmax75 are concerned. This finding indicates the possibility of achieving a satisfactory bronchodilation at beta-stimulant dosages far lower than the standard ones commonly used and therefore minimizing the risk of untoward cardiovascular effects.
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PMID:The combination of fenoterol and ipratropium bromide in bronchial asthma: comparison of the acute effects of two different dosages. 295 94

The efficacies of inhaled doses of fenoterol 200 micrograms, ipratropium bromide 40 micrograms and their combination (200 + 40 micrograms) were compared in a double-blind, placebo-controlled cross-over study in 24 adult patients with stable asthma bronchiale. The tests were performed during 4 consecutive days. The change in bronchial obstruction was assessed by means of spirometry [forced expiratory volume in 1 s (FEV 1.0), forced vital capacity (FVC), peak expiratory flow (PEF)] and body plethysmography [thoracic gas volume (TGV), airway resistance (Raw)] measurements. The values of FEV% and specific airway conductance (SGaw) were calculated. The frequency of side-effects was recorded. During the treatment with the combination of ipratropium bromide and fenoterol the change in the mean SGaw differed highly significantly (p less than 0.001) from placebo in the initial bronchodilator response and at 3, 4 and 5 h. With fenoterol, compared to placebo, a highly significant difference in bronchodilator effect lasted for 4 h, with ipratropium bromide for 3 h. Similarly, a highly significant difference measured with FEV 1.0 during the medication with the combination of ipratropium bromide and fenoterol lasted for 4 h, with fenoterol alone for 2 h, and with ipratropium alone for 1 h. The most harmful side-effect in this group of asthmatics proved to be muscular tremor, caused most often by the combination of ipratropium bromide and fenoterol. The findings of this study suggest that the combination of ipratropium bromide and fenoterol gives a stronger bronchodilatation and a more prolonged effect in asthmatics than ipratropium bromide or fenoterol alone.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Treatment of asthma bronchiale with a combination of ipratropium bromide and fenoterol. 295 26

Two hundred fourteen children with mild to moderate asthma were studied to determine bronchodilator effects 5 min after administration of five different metered dose inhaler (MDI) aerosol formulations available in our country, and results were compared to placebo. Methacholine bronchial challenge was performed by the tidal breathing method, using increasing concentrations until a fall in forced expired volume in 1 s (FEV(1)) >/=20% was achieved (PC20). Immediately after FEV(1) had fallen 20% or more, children were randomly allocated into 1 of 6 groups to receive: salbutamol 200 microg (S), fenoterol 200 microg (F), salbutamol 200 microg + beclomethasone 100 microg (S + B), fenoterol 200 microg + ipratropium bromide 80 microg (F + IB), salmeterol 50 microg (SM), and placebo (P). The bronchodilator effect was determined by measuring FEV(1) 5 min after inhalation of medications. Nonparametric tests were used for statistical analysis. The six groups were similar in anthropometric and in respiratory characteristics. All five inhaled aerosols containing beta-agonists caused a significant bronchodilator effect as compared to placebo. However, the effect was significantly greater in the groups treated with F or F + IB (P < 0.05) compared to other formulations. We conclude that the five types of aerosols used in this study are able to reverse methacholine-induced bronchoconstriction 5 min after inhalation of a bronchodilator.
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PMID:Effect of different inhaled bronchodilators on recovery from methacholine-induced bronchoconstriction in asthmatic children. 1042 12

We wished to determine which resting spirometric parameters best reflect improvements in exercise tolerance and exertional dyspnea in response to acute high-dose anticholinergic therapy in advanced COPD. We studied 29 patients with stable COPD (FEV(1) = 40 +/- 2% predicted [%pred]; mean +/- SEM) and moderate to severe chronic dyspnea. In a double-blind placebo-controlled cross-over study, patients performed spirometry and symptom-limited constant-load cycle exercise before and 1 h after receiving 500 micrograms of nebulized ipratropium bromide (IB) or saline placebo. There were no significant changes in spirometry, exercise endurance, or exertional dyspnea after receiving placebo. In response to IB (n = 58): FEV(1), FVC, and inspiratory capacity (IC) increased by 7 +/- 1%pred, 10 +/- 1%pred, and 14 +/- 2%pred, respectively (p < 0.001), with no change in the FEV(1)/FVC ratio. After receiving IB, exercise endurance time (Tlim) increased by 32 +/- 9% (p < 0.001) and slopes of Borg dyspnea ratings over time decreased by 11 +/- 6% (p < 0.05). Percent change (%Delta) in Tlim correlated best with DeltaIC%pred (p = 0.020) and change in inspiratory reserve volume (DeltaTLC%pred) (p = 0.014), but not with DeltaFVC%pred, DeltaPEFR%pred, or DeltaFEV(1)%pred. Change in Borg dyspnea ratings at isotime near end exercise also correlated with DeltaIC%pred (p = 0.04), but not with any other resting parameter. Changes in spirometric measurements are generally poor predictors of clinical improvement in response to bronchodilators in COPD. Of the available parameters, increased IC, which is an index of reduced resting lung hyperinflation, best reflected the improvements in exercise endurance and dyspnea after IB. IC should be used in conjunction with FEV(1) when evaluating therapeutic responses in COPD.
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PMID:Spirometric correlates of improvement in exercise performance after anticholinergic therapy in chronic obstructive pulmonary disease. 1043 Jul 26

The effects of the long-acting beta(2)-agonist formoterol, the anticholinergic drug oxitropium bromide, and their combination were compared in 16 patients with partially reversible stable COPD. On each of 4 study days patients inhaled both drugs separated by 180 min in alternate sequence, with formoterol being administered in two doses (formoterol 12 microg + oxitropium bromide 200 microg; oxitropium bromide 200 microg + formoterol 12 microg; formoterol 24 microg + oxitropium bromide 200 microg; oxitropium bromide 200 microg + formoterol 24 microg). FEV(1)and FVC were measured baseline and after 30, 60, 120, 180, 210, 240, 300 and 360 min. In terms of onset of action, formoterol performed better than oxitropium bromide. Within the first 180 min after inhalation formoterol 24 microg was the most effective drug (maximal change in FEV(1): formoterol 24 microg = 25.6%, formoterol 12 microg = 21.1%, oxitropium bromide = 18.2%). Increased bronchodilation was obtained when the second drug was added, the sequence formoterol 24 microg + oxitropium bromide being the most effective (maximal change in FEV(1)over baseline: formoterol 24 microg + oxitropium bromide 28.8%, oxitropium bromide + formoterol 24 microg 20.9%, formoterol 12 microg + oxitropium bromide 26.6%, oxitropium bromide + formoterol 12 microg 22.5%). Significant improvement in pulmonary function may be achieved by giving two different bronchodilators in stable COPD patients. The sequence formoterol 24 microg + oxitropium bromide 200 microg seems to be the most effective.
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PMID:Incremental benefit of adding oxitropium bromide to formoterol in patients with stable COPD. 1050 52

We designed a larger, double-blind, randomized, prospective trial to test our hypothesis that patients with acute asthma given combination high dose therapy with ipratropium bromide (IB) and beta(2)-agonists will have greater improvement in pulmonary function and fewer hospital admissions than those given beta(2)-agonists alone. One hundred eighty patients (mean age +/- SD, 34.3 +/- 10.5 yr) who presented to an emergency department (ED) for treatment of an exacerbation of asthma (baseline FEV(1) < 50% of predicted) were assigned in a randomized, double-blind fashion to receive albuterol and placebo (n = 92) or albuterol and IB (n = 88). Both drugs were administered through a metered-dose inhaler and spacer at 10-min intervals for 3 h (24 puffs or 2,880 microg of albuterol and 504 microg of IB each hour). Primary outcome measures were improvement in pulmonary function (FEV(1) or peak expiratory flow [PEF]), and hospital admission rates. In both groups, pulmonary function improved significantly over baseline values (p < 0.01). Subjects who received IB had an overall 20.5% (95% CI: 2.6 to 38.4%) (p = 0.02) greater improvement in PEF and a 48.1% (95% CI: 19.8 to 76.4%) (p = 0.001) greater improvement in FEV(1) from the control group. At the end of protocol (3 h), 39% (n = 36) of patients in the control group and 20% (n = 18) in the IB group were admitted (p = 0.01). The use of high doses of IB reduced the risk of hospital admission 49% (relative risk = 0.51, 95% CI: 0.31 to 0.83). Five (95% CI: 3 to 17) patients would need to be treated with high doses of IB to prevent a single admission. Kaplan-Meier-estimated curves of the proportion of patients who reached the discharge threshold during the 3 h of treatment, showed a significant difference in favor of the IB group (log-rank test = 0.005). A subgroup analysis showed that patients most likely to benefit from the addition of high doses of IB were those with more severe obstruction (FEV(1) </= 30% of predicted) and long duration of symptoms before the ED presentation (>/= 24 h). On the contrary, previous use of inhaled beta(2)-agonists did not modify the admission rate and the pulmonary function response to IB. In conclusion, our data support a substantial therapeutic benefit from the addition of IB to albuterol administered in high doses through MDI plus spacer, particularly in patients with FEV(1) less than 30%, and with long duration of symptoms before the ED presentation (>/= 24 h).
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PMID:First-line therapy for adult patients with acute asthma receiving a multiple-dose protocol of ipratropium bromide plus albuterol in the emergency department. 1085 58

The purpose of the present study was to compare the characteristics of three different exercise tests in evaluating the effects of oxitropium bromide on exercise performance. Thirty-eight males with stable chronic obstructive pulmonary disease (COPD) (FEV(1) = 40.8 +/- 16.5% predicted; mean +/- SD) completed randomized, double-blind, placebo-controlled, crossover studies for each exercise test. The exercise tests were performed 60 min after the inhalation of either oxitropium bromide 400 microg or placebo. The patients performed 6-min walking tests (6MWT) on Days 1 and 2, progressive cycle ergometry (PCE) on Days 3 and 4, and cycle endurance tests at 80% of the maximal workload of PCE on Days 5 and 6. Spirometry was conducted before and at 45 and 90 min after the inhalation. Oxitropium bromide significantly increased FEV(1) as compared with placebo. Oxitropium bromide increased the endurance time significantly, by 19% (p < 0.001), and caused a small but significant increase in the 6-min walking distance by 1% (p < 0.05), but induced no significant increase in maximal oxygen consumption (V O(2)max) in PCE. The responses in these three exercise tests were different, and we conclude that the endurance test was the most sensitive in detecting the effects of inhaled anticholinergic agents on exercise performance in patients with stable COPD. An endurance procedure may be performed to detect clinical changes in evaluating the effects of oxitropium bromide on exercise performance.
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PMID:The effects of oxitropium bromide on exercise performance in patients with stable chronic obstructive pulmonary disease. A comparison of three different exercise tests. 1085 63


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