Long-term effects of almitrine bismesylate on oxygenation during wakefulness and sleep in chronic obstructive pulmonary disease

Gothe, Barbara; Cherniack, Neil S.; Bachand, Romeo T.; Szalkowski, Mary B.; Bianco, Kimberley A.

doi:10.1016/0002-9343(88)90263-x

Cited by 17 publications

(4 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Treatment effects persisted even following treatment cessation, suggestive of a hormonal therapeutic response that is worthy of additional study [52]. Conversely, studies of almitrine [53,54,55], a peripheral chemoreceptor agonist, have not demonstrated a significant therapeutic effect.…”

Section: Drug Treatmentsmentioning

confidence: 99%

Sleep and Sleep Disorders in Chronic Obstructive Pulmonary Disease

Collop

2009

Respiration

View full text Add to dashboard Cite

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death in the US. Numerous studies have demonstrated that sleep disturbances are common in COPD patients, with more prominent complaints in patients with more severe disease and with increasing age. Sleep disturbances may occur due to the effects of breathing abnormalities on sleep and sleep disruption. However, other etiologies may include the medications used to treat COPD, concomitant anxiety and depression, and the presence of comorbid sleep disorders. The respiratory disturbances that occur in these patients during sleep have been evaluated by examining sleep-related oxygen desaturation, reduction in pulmonary function during sleep, and development of hypoventilation during rapid eye movement sleep. Treatment includes use of nocturnal oxygen therapy, noninvasive positive pressure ventilation, and long-acting medications. There has been little study on improving sleep quality beyond treating the respiratory disease, despite the fact that numerous studies show poor sleep quality, a high prevalence of insomnia, and tolerability of newer hypnotic agents in the setting of COPD. This article defines the scope of sleep problems in the setting of COPD, reviews the impact of sleep on ventilation, explores the role of obstructive sleep apnea in the setting of COPD, and reviews therapeutic options.

show abstract

Section: Drug Treatmentsmentioning

confidence: 99%

Sleep and Sleep Disorders in Chronic Obstructive Pulmonary Disease

Collop

2009

Respiration

View full text Add to dashboard Cite

show abstract

“…Almitrine, a piperazine derivative, has been shown to significantly increase arterial oxygen tension (PaoJ and decrease arterial carbon dioxide tension (PacoJ in patients with chronic obstructive pulmonary disease (COPD) [1,2], these beneficial effects being sustained for at least one year [3,4]. The exact mechanism of this improvement in pulmonary gas exchange is not yet established with certainty.…”

mentioning

confidence: 99%

Comparison of the effects of intravenous almitrine and positive end-expiratory pressure on pulmonary gas exchange in adult respiratory distress syndrome

Prost¹,

Desché²,

Jardin³

et al. 1991

Eur Respir J

View full text Add to dashboard Cite

The effects of almitrine on pulmonary gas exchange and haemodynamics were compared to those of positive end-expiratory pressure (PEEP) in 10 patients with a severe adult respiratory distress syndrome (ARDS) who required continuous mechanical ventilation. Haemodynamic and gas exchange measurements were made before and after 30 min of PEEP at a level of 10 cmH2O, then 30 min later, before and at the end of the intravenous infusion of almitrine at a dose of 0.25 mg.kg-1 in 30 min. There was no significant difference between baseline gas exchange and haemodynamic parameters. PEEP and almitrine increased Pao (p = 0.001) from 10.9 to 12.6 kPa and from 10.6 to 12.6 kPa (1 kPa = 7.5 mmHg), respectively, and ratio of venous admixture to total blood flow (Qs/Qt) decreased (p less than 0.001) from 34 to 29% and from 33 to 29%, respectively, the effects of PEEP and almitrine being not significantly different. Neither PEEP nor almitrine caused a significant change in arterial carbon dioxide tension (PaCO2). The haemodynamic parameters did not change significantly with almitrine, whereas mean systemic arterial pressure decreased from 85.4 to 81.1 mmHg (p less than 0.05) with PEEP. These results are consistent with the hypothesis that both treatments improve ventilation/perfusion (VA/Q) distributions, by an increase in functional residual capacity in the case of PEEP and a redistribution of pulmonary perfusion in the case of almitrine.

show abstract

“…The drug improves ventilation-perfusion matching even at lower dosage and was shown to improve both awake and nocturnal oxygenation in COPD patients, with a less pronounced effect on PaCO 2 (Connaughton et al, 1985;Gothe et al, 1988). Its stimulant effects are only present at high dosage and probably mediated by calcium-dependent potassium channel inhibition.…”

Section: Almitrine Bismesylatementioning

confidence: 99%