Inhaled Atropine Sulfate in Acute Asthma

Abstract

We administered inhaled atropine sulfate to acute asthmatics already receiving therapeutic doses of adrenergic agonists, theophylline, and corticosteroids. Following atropine, hyperinflation diminished whereas vital capacity and expiratory flow rates breathing air and helium-oxygen increased (p < 0.025 – p < 0.005). Initial density dependence correlated inversely with changes in density dependence after atropine (r = – 0.69, p < 0.001). We conclude that: (1) inhaled atropine sulfate was effective therapy for acutely ill asthmatics already being treated with multiple antiasthmatic agents; (2) atropine caused large and peripheral airways bronchodilatation, and (3) the predominant site of bronchodilatation after atropine was related to the site of flow limitation before atropine

Comparison of Once-a-Day and Twice-a-Day Theophylline in Asthma

“…1). This observa tion corroborates previous results in sub jects with asthma and chronic airflow ob struction [20][21][22] and suggests that: (1) the site of bronchodilation after theophylline is, as with inhaled atropine and beta-ago nists [20][21][22], related to the predominant site of airflow limitation prior to adminis tration of bronchodilators, and (2) theo phylline compounds dilate both large and peripheral airways; this latter observation corroborates findings from a previous in vitro study [23].…”

The assessment and management of adults with status asthmaticus.

“…Atropine sulfate is the least desirable of these drugs, and it is not recommended in the treatment of acute asthma. Although atropine improves airflow in acute asthma (107), it is inferior to metaproterenol as a sole drug and does not produce further improvement in patients who have already received metaproterenol (108). Atropine is well absorbed from the airways because of its tertiary amine structure, and it thus causes unwanted systemic effects.…”