Acute effect of pretreatment with single conventional dose of salmeterol on dose-response curve to oxitropium bromide in chronic obstructive pulmonary disease

被引:11
作者
Cazzola, M
Di Perna, F
Centanni, S
Califano, C
Donner, CF
D'Amato, M
D'Amato, G
机构
[1] A Cardarelli Hosp, Div Pneumol & Allergol, Naples, Italy
[2] Univ Milan, Sch Med, San Paolo Hosp, Resp Dis Unit, Milan, Italy
[3] S Maugeri Fdn, Inst Care & Res, Med Ctr Rehabil, Div Pneumol, Veruno, Italy
关键词
salmeterol; oxitropium bromide; combination therapy; chronic obstructive pulmonary disease;
D O I
10.1136/thx.54.12.1083
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Background-An earlier study documented that, in patients with chronic obstructive pulmonary disease (COPD), addition of ipratropium bromide at the clinically recommended dose (40 mu g) does not produce any further bronchodilation than that achieved with salmeterol 50 mu g alone. However, the dose of ipratropium bromide needed to produce near maximal bronchodilation is several times higher than the customary dosage. The full therapeutic potential of combined salmeterol plus an anticholinergic drug can therefore only be established using doses higher than those currently recommended in the marketing of these agents. A study was undertaken to examine the possible acute effects of higher than conventional doses of an anticholinergic agent on the single dose salmeterol induced bronchodilation in patients with stable and partially reversible COPD. Methods-Thirty two outpatients received 50 pg salmeterol or placebo. Two hours after inhalation a dose-response curve to inhaled oxitropium bromide (100 mu g/puff) or placebo was constructed using one puff, one puff, two puffs, and two puffs-that is, a total cumulative dose of 600 mu g oxitropium bromide. Dose increments were given at 20 minute intervals with measurements being made 15 minutes after each dose. On four separate days all patients received one of the following: (1) 50 pg salmeterol + 600 pg oxitropium bromide; (2) 50 pg salmeterol + placebo; (3) placebo + 600 pg oxitropium bromide; (4) placebo + placebo. Results-Salmeterol induced a good bronchodilation (mean increase 0.272 1; 95% CI 0.207 to 0.337) two hours after its inhalation. Oxitropium bromide elicited an evident dose-dependent increase in forced expiratory volume in one second (FEV1) and this occurred also after pretreatment with salmeterol with a further mean maximum increase of 0.152 1 (95% CI of differences 0.124 to 0.180). Conclusions-This study shows that acute pretreatment with 50 pg salmeterol does not block the possibility of inducing more bronchodilation with an anticholinergic agent when a higher than normal dosage of the muscarinic antagonist is used.
引用
收藏
页码:1083 / 1086
页数:4
相关论文
共 50 条
[41]   Effect of formoterol, tiotropium, and their combination in patients with acute exacerbation of chronic obstructive pulmonary disease: A pilot study [J].
Di Marco, Fabiano ;
Verga, Massimo ;
Santus, Pierachille ;
Morelli, Nicoletta ;
Cazzola, Mario ;
Centanni, Stefano .
RESPIRATORY MEDICINE, 2006, 100 (11) :1925-1932
[42]   EFFECT OF DOXOFYLLINE COMBINED WITH TIOTROPIUM BROMIDE ON THE EFFICACY AND AIRWAY REMODELING STATUS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE [J].
Lian, Yufei ;
Zhang, Yue ;
Feng, Yunjia ;
Qiu, Xuejia ;
Gao, Shuhui ;
Yan, Li .
ACTA MEDICA MEDITERRANEA, 2022, 38 (02) :1329-1334
[43]   Evaluation of pulsed dose oxygen delivery during exercise in patients with severe chronic obstructive pulmonary disease [J].
Garrod, R ;
Bestall, JC ;
Paul, E ;
Wedzicha, JA .
THORAX, 1999, 54 (03) :242-244
[44]   Novel cosuspension metered-dose inhalers for the combination therapy of chronic obstructive pulmonary disease and asthma [J].
Lechuga-Ballesteros, David ;
Noga, Brian ;
Vehring, Reinhard ;
Cummings, R. Harris ;
Dwivedi, Sarvajna K. .
FUTURE MEDICINAL CHEMISTRY, 2011, 3 (13) :1703-1718
[45]   Exploration of quantitative-effectiveness association between acupuncture temporal parameters and stable chronic obstructive pulmonary disease: A systematic review and dose-response meta-analysis of randomized controlled trials [J].
Luo, Qin ;
Sun, Mingsheng ;
Xu, Guixing ;
Tian, Hao ;
Yang, Chunyan ;
Huang, Liuyang ;
Li, Xi ;
Wang, Ziwen ;
Lu, Guangbing ;
Yang, Zuoqin ;
Ji, Laixi ;
Liang, Fanrong .
COMPLEMENTARY THERAPIES IN MEDICINE, 2024, 82
[46]   The effect of CD33 expression on inflammatory response in chronic obstructive pulmonary disease [J].
Zhang, Li-Xin ;
Ye, Jun ;
Chen, Ya-bao ;
Peng, Hai-lin ;
Chen, Xiu ;
Liu, Ling ;
Jiang, Ai-gui ;
Huang, Jun-xing .
IMMUNOLOGICAL INVESTIGATIONS, 2013, 42 (08) :701-710
[47]   NOCTURNAL OXYGEN-SATURATION IN ADVANCED CHRONIC OBSTRUCTIVE PULMONARY-DISEASE AFTER A MODERATE DOSE OF ETHANOL [J].
BRANDER, PE ;
KUITUNEN, T ;
SALMI, T ;
PARTINEN, M .
EUROPEAN RESPIRATORY JOURNAL, 1992, 5 (03) :308-312
[48]   The effect of ipratropium bromide on intraocular pressure in patients with chronic obstructive pulmonary disease:: An open-label study [J].
Polatli, M ;
Dayanir, V ;
Polatli, Ö ;
Özkan, SB ;
Çildag, O .
CURRENT THERAPEUTIC RESEARCH-CLINICAL AND EXPERIMENTAL, 2002, 63 (06) :380-387
[49]   Effect of different doses of Budesonide combined with Tiotropium bromide inhalation on elderly patients with chronic obstructive pulmonary disease [J].
Yu, Jianhong ;
Ni, Jianchao ;
Chen, Xindong ;
Fang, Yuanyuan ;
Fu, Suna .
PAKISTAN JOURNAL OF MEDICAL SCIENCES, 2024, 40 (07) :1338-1344
[50]   Formoterol/budesonide pressurized metered-dose inhaler: A guide to its use in chronic obstructive pulmonary disease [J].
Lyseng-Williamson K.A. .
Drugs & Therapy Perspectives, 2014, 30 (8) :269-275