Nebulized bronchodilators for outpatient management of stable chronic obstructive pulmonary disease

The American Journal of Medicine
G L Colice

Abstract

The bronchodilator efficacy, safety, and persistence of effect of the anticholinergic agent ipratropium bromide and the beta-adrenergic agonist albuterol, both given by nebulization, were compared in 223 patients with stable, severe chronic obstructive pulmonary disease (COPD). The study was a randomized, double-blind, parallel group trial conducted over 85 days. Patients took the study drugs (either 500 micrograms of ipratropium bromide or 2.5 mg of albuterol) three times daily on an outpatient basis throughout the study. The acute bronchodilator responses to nebulized ipratropium bromide and albuterol were studied on days 1, 43, and 85. The forced expiratory volume in 1 second (FEV1) response was similar for both drugs on day 1 (33% peak increase after ipratropium bromide and 36% peak increase after albuterol). However, albuterol's effect on FEV1 decreased over time. Clinical improvement was noted in both study groups, but the ipratropium bromide group had a greater symptomatic benefit. Patients receiving ipratropium bromide scored higher on a quality-of-life questionnaire evaluating dyspnea, fatigue, emotional function, and mastery. Side effects were relatively infrequent and generally mild for both study drugs. These result...Continue Reading

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Citations

Sep 15, 2006·Journal of General Internal Medicine·Shelley R SalpeterEdwin E Salpeter
Dec 8, 2009·Advances in Therapy·Robert A FlynnMarcus P Kennedy
Oct 27, 2004·Clinical Cornerstone·Dick D Briggs, Dennis E Doherty
Dec 7, 2017·Postgraduate Medicine·Michael DePietroMichael Riebe
Apr 21, 2006·The Cochrane Database of Systematic Reviews·S AppletonJ Muhammad
Jan 15, 2015·Journal of Medicinal Chemistry·Paolo Montuschi, Giovanni Ciabattoni

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