Glycopyrrolate and Atropine Inhalation: Comparative Effects on Normal Airway Function<sup>1,</sup><sup>2</sup>

Gal, Thomas J.; Suratt, Paul M.; Lu, Jau-Yeong

doi:10.1164/arrd.1984.129.5.871

Cited by 28 publications

(14 citation statements)

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“…Glycopyrrolate, a quaternary ammonium derivative of atropine, has been reported to have antisecretory activities without the side effects of atropine [28].…”

Section: Anticholinergic Agentsmentioning

confidence: 99%

Therapeutic approaches to mucus hypersecretion

Abe

Baraniuk

2005

Curr Allergy Asthma Rep

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Mucolytic and related agents have been in use since prehistoric times. Although widely prescribed and used extensively in over-the-counter preparations, their efficacy and mechanisms of action remain in doubt. These agents belong to several distinct chemical classes. Mucolytic agents such as N-acetyl-cysteine are thiols with a free-sulfhydryl group. They are assumed to break disulfide bonds between gel-forming mucins and thus reduce mucus viscosity. Mucokinetic agents are thiols with a blocked sulfhydryl group. Expectorants such as guaifenesin increase mucus secretion. They may act as irritants to gastric vagal receptors, and recruit efferent parasympathetic reflexes that cause glandular exocytosis of a less viscous mucus mixture. Cough may be provoked. This combination may flush tenacious, congealed mucopurulent material from obstructed small airways and lead to a temporary improvement in dyspnea or the work of breathing. The roles of anticholinergic agents, DNase, and other drugs are also discussed with regard to their roles in reducing mucus production in rhinitis and other airway diseases.

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“…Glycopyrrolate, a quaternary ammonium derivative of atropine, has been reported to have antisecretory activities without the side effects of atropine [28].…”

Section: Anticholinergic Agentsmentioning

confidence: 99%

Therapeutic approaches to mucus hypersecretion

Abe

Baraniuk

2005

Curr Allergy Asthma Rep

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“…GAL et al [1] showed that GP, given intravenously or as an aerosol, produced a significant increase in FEV1 which lasted up to 6 h. Subsequent studies confirmed the prolonged bronchodilating effect of GP in asthma, some studies [3,5] demonstrating a bronchodilator effect up to 12 h. GILMAN et al [2] also showed that the increase in FEV1 produced by GP was comparable to that of MP. The present study extends these previous observations to patients with stable COPD.…”

Section: Discussionmentioning

confidence: 99%

“…SCHROECKENSTEIN et al [5] found that GP dosages of 0.5 or 1.0 mg produced equivalent bronchodilation. In a study comparing dose-response curves in normals, GAL et al [1] found that the greater the dosage of GP the more sustained the bronchodilating effect. However, the duration of bronchodilation produced by GP dosages greater than 1.5 mg was marginally better than that produced by a dose of 0.8 mg.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the higher dosages were associated with more side-effects. GAL et al [1], therefore, concluded that GP dosages of 1.0 mg could be used effectively with virtually no side-effects.…”

Section: Discussionmentioning

confidence: 99%

“…Concurrent administration of glycopyrrolate and metaproterenol produces additional bronchodilation that is primarily apparent during the bronchodilator effect of metaproterenol. Eur Respir J., 1996, 9, 100- Glycopyrrolate (GP), a quarternary ammonium compound, is an anticholinergic agent that has primarily been used with anaesthesia to reduce gastric acidity and salivary secretions or to reverse neuromuscular blockade [1]. Recently, GP has been used as a bronchodilator in patients with asthma [2][3][4][5].…”

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confidence: 99%

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Comparison of nebulized glycopyrrolate and metaproterenol in chronic obstructive pulmonary disease

Tzelepis¹,

Komanapolli²,

Tyler³

et al. 1996

Eur Respir J

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We assessed the bronchodilating effect of glycopyrrolate (GP) and compared it with that of metaproterenol (MP), alone and in combination (GP+MP), in patients with chronic obstructive pulmonary disease (COPD).In a double-blind study, 11 patients (aged (mean±SD) 69±6 yrs; forced expiratory volume in one second (FEV1) 1.2±0.4 L) with stable COPD inhaled nebulized GP 1.0 mg, MP 15 mg, or GP 1.0 mg + MP 15 mg. Spirometry was performed before inhalation and at hourly intervals for 8 h after inhalation.It was found that GP produced a bronchodilating effect that was about equal to that of MP but lasted longer (8 vs 5 h). The combination of GP and MP produced a bronchodilating effect that was greater than that of either drug alone and was evident mostly during the effect of MP. The mean peak percentage improvement in FEV1 over baseline was 35% for GP+MP and 25% for either drug alone.These data suggest that nebulized glycopyrrolate is an effective bronchodilator in some patients with chronic obstructive pulmonary disease. Concurrent administration of glycopyrrolate and metaproterenol produces additional bronchodilation that is primarily apparent during the bronchodilator effect of metaproterenol. Eur Respir J., 1996, 9, 100- Glycopyrrolate (GP), a quarternary ammonium compound, is an anticholinergic agent that has primarily been used with anaesthesia to reduce gastric acidity and salivary secretions or to reverse neuromuscular blockade [1]. Recently, GP has been used as a bronchodilator in patients with asthma [2][3][4][5]. This study was designed to investigate the bronchodilator effect of GP in patients with stable chronic obstructive pulmonary disease (COPD) and compare it with that of another commonly used bronchodilator, the β-adrenergic agonist metaproterenol (MP). In addition, we examined whether the concurrent administration of GP and MP provided any further bronchodilation than GP alone in this group of patients. MethodsEleven men with diagnoses of chronic bronchitis, emphysema, or both [6] were recruited from out-patient pulmonary clinics to participate in the study (table 1). Stability of their disease was defined as no hospitalizations or change in therapy over a 6 month period prior to the study. All patients had a forced expiratory volume in one second/forced vital capacity ratio (FEV1/FVC) of less than 70%, and a history of cigarette smoking. A positive bronchodilator response following inhalation of metaproterenol, as defined by the American Thoracic Society (ATS) criteria [6], was documented during previous pulmonary function testing. None of the subjects had a history of bronchial asthma or were on oral steroids. The study was approved by the institutional review committee and informed consent was obtained from all patients.Measurements of FVC and FEV1 were performed on a Collins Eagle One spirometer (Braintree, MA, USA). The medications were mixed with normal saline to a total volume of 7.5 mL and aerosolized using a Misty-Neb nebulizer (Airlife) with a flow rate of 10 L·min -1 delivered over ...

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Current and Emerging Therapies in Chronic Obstructive Pulmonary Disease

Montana¹,

Dyke²,

Fox³

et al. 2010

Burger's Medicinal Chemistry and Drug Discovery

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Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that is a leading cause of morbidity and mortality worldwide with an overall prevalence in adults >40 years estimated at 9–10%. The World Health Organization (WHO) estimates that, by 2020, COPD will be the third leading cause of mortality and the fifth leading cause of morbidity in the world. This smoking‐related disease is characterized by progressive airway obstruction that, unlike asthma, is relatively insensitive to bronchodilators and to the classic anti‐inflammatory therapy, corticosteroids. Current therapy focuses mainly on reducing symptoms using inhaled short‐acting and long‐acting bronchodilators either as monotherapies or in combination with inhaled corticosteroids. During the last decade, the pharmaceutical industry has focused on treating COPD distinctly from asthma but no novel agents that target the disease itself have been launched as therapies for this disease. As our understanding of the pathology of COPD has increased it has been established that the progressive pulmonary inflammation that is associated with COPD relates to disease severity. Thus, it is anticipated that drugs that reduce pulmonary inflammation will provide effective, disease‐modifying therapies. Here, we consider the potential of anti‐inflammatory drugs that are currently in clinical development for COPD and discuss how these might reduce pulmonary inflammation in this disease.

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Glycopyrrolate and Atropine Inhalation: Comparative Effects on Normal Airway Function^1,²

Cited by 28 publications

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Therapeutic approaches to mucus hypersecretion

Therapeutic approaches to mucus hypersecretion

Comparison of nebulized glycopyrrolate and metaproterenol in chronic obstructive pulmonary disease

Current and Emerging Therapies in Chronic Obstructive Pulmonary Disease

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Glycopyrrolate and Atropine Inhalation: Comparative Effects on Normal Airway Function1,2

Cited by 28 publications

References 0 publications

Therapeutic approaches to mucus hypersecretion

Therapeutic approaches to mucus hypersecretion

Comparison of nebulized glycopyrrolate and metaproterenol in chronic obstructive pulmonary disease

Current and Emerging Therapies in Chronic Obstructive Pulmonary Disease

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Glycopyrrolate and Atropine Inhalation: Comparative Effects on Normal Airway Function^1,²