Variation of Drug Action on Airway Obstruction in Man

Altounyan, R. E. C.; Patterson, Russel H.

doi:10.1097/00132586-196702000-00019

Cited by 12 publications

(19 citation statements)

References 2 publications

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“…If a drug possesses bronchodilator activity, it is impossible to define its site of action in EIA, but sodium cromoglycate must clearly act in a different way from the other drugs and is effective only in preventing induced asthma. Much attention has recently been paid to the vagus, and it has been suggested that antigen-induced asthma, histamineinduced asthma, and possibly other types of asthma may have a final common pathway through a vagal reflex (Altounyan, 1964;Booij-Noord et al, 1970;Yu et al, 1972). It seems inherently unlikely that this could be true for EIA since our study has shown a significant atropine block in only about 60% of children, despite using a dose which caused bronchodilatation in every case (doubling the specific airways conductance which we measured plethysmographically) and raising the resting heart-rate by a mean of 12 beats per minute.…”

Section: Discussionmentioning

confidence: 99%

“…Choline theophyllinate was given by mouth and sodium cromoglycate by the standard spinhaler device. Atropine was given by nebulization of a 0O2% solution of atropine methonitrate using a Wright's nebulizer for 3 minutes at a flow rate of 9 1/min (modified from Altounyan (1964)). Placebos were given by mouth, resembling salbutamol tablets in one child, by inhaled aerosol propellant in one child, by spinhaler as used for cromoglycate in 13 children, and again by nebulization of saline to simulate atropine in the seven children studied in the second period.…”

Section: Methodsmentioning

confidence: 99%

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Inhibition of exercise-induced asthma by different pharmacological pathways.

Godfrey¹,

König²

1976

Thorax

166

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Godfrey, S. and Konig, P. (1976). Thorax, 31,[137][138][139][140][141][142][143]. Inhibition of exercise-induced asthma by different pharmacological pathways. Exercise-induced asthma (EIA) was provoked by standardized treadmill running for 6 minutes in 15 asthmaticchildren. The tests were carried out after the administration of a placebo, salbutamol, sodium cromoglycate, choline theophyllinate, and atropine methonitrate aerosol in randomized fashion on different days. The mean post-exercise percent fall in peak expiratory flow rate was 45-2, 4-1, 19-6, 18-3, and 24-9 respectively. The proportion of children having significant amelioration of their EIA compared with those taking the placebo was 100% for salbutamol, 80% for cromoglycate and theophyllinate, and 60% for atropine. Salbutamol, choline theophyllinate, and atropine were bronchodilators at rest whereas cromoglycate was not, and the ability to suppress EIA was unrelated to bronchodilator effect. Even after bronchodilatation at rest, further bronchodilatation occurred during the exercise period.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Inhibition of exercise-induced asthma by different pharmacological pathways.

Godfrey¹,

König²

1976

Thorax

166

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“…The numbers of patients studied were small, however, and some variations of the subcutaneous adrenaline and atropine responses occurred within the groups. This is worthy of further study, since a poor response to aerosol atropine compared with aerosol isoprenaline has been observed in patients whose airways obstruction responds to corticosteroids, and similar responses to aerosol atropine and isoprenaline in patients whose bronchospasm was unaffected by corticosteroid therapy have also been reported (Altounyan, 1964;Gandevia, 1965). Aerosol atropine methonitrate produces a more rapid response in patients regarded as having chronic bronchitis than in patients with uncomplicated asthma (Gandevia, 1965).…”

Section: Discussionmentioning

confidence: 73%

“…Cholinergic drugs have long been known to have bronchodilator properties (Finnegan, 1950), and it has been suggested that there are different responses to atropine in asthma and in chronic bronchitis, the variation in response having some correlation with the response to corticosteroid drugs (Altounyan, 1964).…”

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confidence: 99%

A comparison of responses to bronchodilator drugs in chronic bronchitis and chronic asthma

Crompton¹

1968

Thorax

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“…Altounyan postulated a delayed effect on membrane permeability to account for a similar variation in the effect of anticholinergic agents on smooth muscle tone in vitro, the effect varying with local concentrations of histamine. 4 Whatever the explanation, we cannot recommend the addition of ipratropium to treatment regimens in acute severe childhood asthma.…”

Section: Discussionmentioning

confidence: 99%

Nebulised ipratropium and salbutamol in asthma.

Storr¹,

Lenney²

1986

Archives of Disease in Childhood

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SUMMARY Treatment with nebulised salbutamol or a mixture of salbutamol and ipratropium was given to 138 children. Length of hospital stay and number of nebulised doses required did not differ. In severe asthma response was greater with salbutamol alone. In mild asthma response was greater with combined treatment.Ipratropium bromide is an effective bronchodilator in children.L3 There are potential advantages in combining it with a beta adrenergic agent in treating asthma.2 We aimed to discover whether the addition of ipratropium to treatment with salbutamol would lead to a therapeutic response greater than that attainable with salbutamol alone. PatientsAll patients admitted to our hospital because of asthma between October 1984 and March 1985 were studied. There were 138 children, 95 boys and 43 girls. Their ages ranged from 11 months to 15 years, with a mean of 5-0 years. Thirteen were aged under 18 months. One hundred and five (76%) had had one or more previous admissions for asthma. MethodsThe children were randomly allocated to a salbutamol or a combined treatment group. The former received 5 mg salbutamol and the latter 5 mg salbutamol mixed with 0-25 mg ipratropium in each nebuliser. Nebuliser solutions were of equal tonicity and were administered double blind.There were 70 patients in the salbutamol group and 68 in the combined treatment group. Standardised admission sheets were used, which incorporated a score of clinical severity (scale: 0-10). The mean admission scores in each group were almost identical (4.69 and 4.52). The age and sex distribution were similar, as were the past history, family history, parental smoking history, and drugs used before admission.Nebulisers were given within set limits at the discretion of the nursing staff. Steroids were given to children not responding satisfactorily to nebulised treatment, and intravenous aminophylline was given to children in severe respiratory_distress.In those old enough to produce accurate readings peak expiratory flow rates were measured immediately before and 20 minutes after treatment (except at night). Percentage changes in the peak expiratory flow rate were stratified so that responses were compared at similar degrees of severity. All statistics were analysed using the Wilcoxon rank sum method for unpaired data. Results

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Variation of Drug Action on Airway Obstruction in Man

Cited by 12 publications

References 2 publications

Inhibition of exercise-induced asthma by different pharmacological pathways.

Inhibition of exercise-induced asthma by different pharmacological pathways.

A comparison of responses to bronchodilator drugs in chronic bronchitis and chronic asthma

Nebulised ipratropium and salbutamol in asthma.

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