Assessment of a combination of doses of fenoterol and ipratropium suitable for a single metered-dose aerosol

Addis, G. J.; Barclay, Joyce; Chang, En-Pei

doi:10.1007/bf00563114

Cited by 9 publications

(4 citation statements)

References 3 publications

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“…Several studies have demonstrated that the combination of IB and fenoterol has a more potent and long-lasting bronchodilator effect than that of each individual drug [1,3]. The patients with asthma can be differentiated, on the basis of response to inhaled bronchodilator, into 'flow re sponders', i.e., those with a prevalent in crease in How, and 'volume responders', i.e., those with a prevalent increase in forced expiratory volumes; IB could have a major bronchodilator effect on central airways with a prevalent increase in forced expiratory volumes, while fenoterol could have a prevalent action on small airways with increase in flows [5,8].…”

Section: Discussionmentioning

confidence: 99%

“…On this basis, in the last few years several studies have demonstrated that a combination between an anticholinergic and a beta-adrenergic drug, like Duovent, is useful in obtaining more effective ther apeutic action and/or reducing the single drug doses [1,3]. Only few data are avail able on this combination and the develop ment of tolerance, i.e., a decreased respon siveness to the drug occurring with predic table frequency when specific receptors are chronically stimulated by prolonged therapy with inhaled Duovent.…”

Section: Introductionmentioning

confidence: 99%

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Tolerance to Inhaled Duovent

Carlone¹,

Angelici²,

Palange³

et al. 1986

Respiration

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Fenoterol with ipratropium bromide (Duovent) is a recently used combination between an anticholinergic and a beta-adrenergic drug useful in obtaining a more effective bronchodilatation and/or reducing the single drug doses. It has been suggested that, as in the case of beta-agonists, its clinical efficacy may be limited by the development of tolerance. We studied the effects of inhaled Duovent in 15 asthmatic patients for 3 months, using a rigidly controlled protocol. Appropriate serial physiological measurements were made at regular intervals during the 90-day study. In all instances the day-one bronchodilator response was significant, prompt and sustained: at 1, 4, 8 and 12 weeks the response was statistically the same as on day 1. It is concluded that, when the important variables are properly controlled, no evidence of tolerance to long-term therapy with Duovent is demonstrable.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tolerance to Inhaled Duovent

Carlone¹,

Angelici²,

Palange³

et al. 1986

Respiration

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“…Several authors have investigated the combined use of ipratropium bromide and bela^-agonists, showing a greater or more prolonged response than that which occurred with individual drugs [Addis et al, 1979;Pierce et al, 1979]. According to previous reports, we have observed in our patients a greater persistence of broncho dilating action with Duovent than with terbutaline, as shown by the comparison of the basal values on the 7th and 14th days for the majority of parameters ex amined, without reduction in pharmaco dynamic response following inhalation of the drug.…”

Section: Discussionmentioning

confidence: 99%

Acute on Chronic Comparative Effects of a Combination of Fenoterol-Ipratropium Bromide and Terbutaline in Patients with Chronic Obstructive Lung Disease

Grassi¹,

Bruni²,

Peccini³

et al. 1986

Respiration

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Twenty patients suffering from chronic obstructive lung disease (COLD) were examined in a randomized intra-individual single-blind study in order to compare the ventilatory response, tolerance and side-effects of a combination of 40 µg ipratropium bromide and 100 µg fenoterol (Duovent) with 250 µg terbutaline, both given by inhalation (2 puffs) three times a day. The ventilatory parameters FVC, FEV₁, sGaw, RV and PaO₂, tested on the 7th and 14th days at 0, 30, and 240 min after the morning administration of the two drugs, showed significant differences between treatments, revealing a greater persistence of bronchodilator effect and a more prolonged duration of action with Duovent than with terbutaline. We believe that the results obtained suggest the usefulness of a combination of anti-cholinergic and beta₂-agonist drugs in the treatment of reversible bronchial obstruction in COLD, where even the parasympathetic nervous system seems to play an important role. The observed clinico-functional effects (intensity and duration of bronchodilatation) together with the lack of side-effects permit us to affirm that Duovent is a rational pharmacologic combination which represents real progress in the difficult treatment of COLD patients

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“…The combination of fenoterol and ipratropium bromide has been shown to produce a greater bronchodilator response than that achieved by either agent alone both in asthma (Martin, Berend and Harrison, 1979) and chronic bronchitis (Addis, Barclay and Chang, 1979;Anderson, Jariwalla and Turnbull, 1980). This combination has recently become available in a single metered dose inhaler.…”

Section: Introductionmentioning

confidence: 99%