Respiratory stimulant use in chronic obstructive pulmonary disease

OBJECTIVE: To evaluate the use of respiratory stimulants in chronic obstructive pulmonary disease (COPD). DATA SOURCES: MEDLINE (1966-July 2003) and EMBASE (1980-3rd quarter 2003) were searched using the search terms medroxyprogesterone acetate, acetazolamide, chronic obstructive pulmonary disease, and chronic obstructive lung disease. DATA SYNTHESIS: Trials are reviewed evaluating ventilatory parameters with acetazolamide and/or medroxyprogesterone in patients with COPD. All studies found improvements in ventilatory parameters, but failed to demonstrate improvements in survival or quality of life. CONCLUSIONS: Significant improvement in arterial blood gas and ventilatory parameters was reported in COPD patients after acetazolamide and medroxyprogesterone treatment; however, with no improvement in survival or quality of life, the place of these drugs in therapy remains unknown.