Comparison of ipratropium bromide and albuterol in chronic obstructive pulmonary disease: a three-center study

Article Abstract:

Chronic obstructive pulmonary disease (COPD) reduces the amount of air that enters the lungs and makes breathing difficult. COPD is treated with drugs that open the air passages in the lungs (bronchodilators). Several different types of drugs have been used to treat patients with COPD, including anticholinergic agents (atropine, ipratropium bromide), beta-adrenergic agonists (albuterol, salmeterol), and theophylline. Previous studies have reported that anticholinergic agents produce greater and longer lasting bronchodilation than beta-adrenergic agonists. Therefore, a study was performed to compare the effectiveness of ipratropium (36 micrograms) with albuterol (180 micrograms) in treating patients with COPD; a trial with a placebo was also performed. The study included 72 patients with COPD who were heavy cigarette smokers and were between the ages of 35 and 80. Lung function was determined before and after treatment with each drug by measuring the amount of air that could be forcefully exhaled from the lungs in one second (FEV1, forced expiratory volume) and the total amount of air that could be forcefully exhaled from the lungs after taking a deep breath (FVC, forced vital capacity). Ipratropium was more effective than albuterol in increasing the FEV1 at three, four, and five hours after drug treatment, and in increasing the FVC at one, two, three, four, and five hours after treatment. Over the entire six-hour treatment period, ipratropium was 25 percent more effective in increasing FEV1 and 50 percent more effective in increasing FVC than albuterol. Both drug treatments produced few side effects. It is concluded that ipratropium bromide is more effective than albuterol in treating patients with COPD. (Consumer Summary produced by Reliance Medical Information, Inc.)

Albuterol

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Acute bronchodilating effects of ipratropium bromide and theophylline in chronic obstructive pulmonary disease

Article Abstract:

More than 20 million people living in the US have chronic obstructive pulmonary disease (COPD), which is the fifth leading cause of death in this country. Theophylline (also called aminophylline) is one of the most commonly prescribed drugs for treating COPD. This drug has been reported to reduce symptoms of shortness of breath and to improve lung muscle function. However, this drug has toxic side effects that may limit its use, particularly in elderly patients with heart disease. Ipratropium bromide, a drug that dilates the air passages in the lungs, has been shown to be effective in treating patients with COPD. When this drug is inhaled it is not absorbed into the blood, so it has fewer side effects. A study was performed to compare the effectiveness of theophylline with ipratropium bromide in treating patients with COPD. Lung function was evaluated in 21 patients with COPD before and after treatment with each drug by measuring the amount of air that could be forcefully exhaled from the lungs in one second (FEV1, forced expiratory volume). Treatment with ipratropium bromide increased the FEV1 by at least 15 percent in 90 percent of the patients tested, while theophylline produced a 15 percent increase in the FEV1 in 50 percent of the patients. The average increase in FEV1 over a six-hour period was 18 percent for ipratropium and 8 percent for theophylline. Ipratropium produced a longer lasting effect (3.8 hours) than theophylline (2.4 hours). It is concluded that ipratropium is more effective than theophylline in dilating or opening lung air passages in patients with COPD. (Consumer Summary produced by Reliance Medical Information, Inc.)

Theophylline

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Oxygen transport and oxygen consumption during supplemental oxygen administration in patients with chronic obstructive pulmonary disease

Article Abstract:

Chronic obstructive pulmonary disease (COPD) is a condition in which the lungs are unable to take in adequate amounts of air. Normally, the ability to use oxygen is independent of the amount of oxygen delivered above a certain point. In patients with COPD, oxygen consumption is dependent on the amount of oxygen delivered. The difference between the amount of oxygen consumed and the amount of oxygen delivered increases during exercise, when oxygen demands are increased. To evaluate whether or not oxygen consumption depends on the supply of oxygen during exercise, 12 stable COPD patients were studied. The oxygen delivery to patients given a lower percentage of oxygen than that found in room air and those given 26 percent supplemented oxygen were compared. The amount of oxygen consumed by patients with COPD did not increase when the concentration of oxygen in the air was increased. It is presumed that this was a function of poor cardiac output (the amount of blood pumped from the heart into the circulation), which is common in patients with COPD. Stable COPD patients who do not receive a supplemental oxygen supply may not have sufficient oxygen delivery even when at rest. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Causes of, Hypoxia, Anoxia, Oxygen consumption, Oxygen consumption (Metabolism), Emphysema, Pulmonary, Emphysema

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