Acute on chronic comparative effects of a combination of fenoterol-ipratropium bromide and terbutaline in patients with chronic obstructive lung disease

Abstract

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 micrograms ipratropium bromide and 100 micrograms fenoterol (Duovent) with 250 micrograms 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 beta 2-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.