Comparison of the effects of inhaled SCH 1000 and fenoterol on exercise-induced bronchospasm in children

Abstract

The effect of 40 microgram of SCH 1000 (ipratropium bromide, an anticholinergic agent) on bronchodilation and suppression of exercise-induced bronchospasm (EIB) was compared with 400 microgram of fenoterol and a placebo in a single-blind controlled study. Twenty-seven randomly selected asthmatic children performed a standardized treadmill exercise challenge and the 17 children who were shown to have EIB continued in the study. Pulmonary function was evaluated before and after drug administration and exercise. When individual results were analyzed and grouped according to the responsiveness of EIB to the drugs, two patterns emerged: (1) the EIB was more severe in those (6/17) children who did not respond to either drug than in the rest of children; (2) the resting pulmonary function was significantly better in the children (4/17) who responded to both drugs than in those (7/17) who responded to fenoterol alone. In conclusion SCH 1000 was shown to be an effective bronchodilator comparable to, but no better than, fenoterol. It had minimal side effects. As an EIB inhibitor it depended on relatively normal base line pulmonary function and only a moderate deterioration following exercise, whereas fenoterol depended on the exercise response alone. Although anticholinergic drugs are not very extensively used, SCH 1000 may be useful in some patients where the beta 2 adrenergic drugs cause signficant side effects or are contraindicated.