Comparison of the acceptability of the Ventolin metered-dose inhaler and the Bricanyl Turbuhaler.

One hundred fifty-nine asthmatic patients aged 19 to 76 years completed an open crossover-designed study comparing the acceptability of the Bricanyl Turbuhaler (BTH) and the Ventolin metered-dose inhaler (VMDI). The doses given were presumed to be equiactive. Each treatment period lasted for 14 days. Patients registered morning and evening peak expiratory flow rate (PEFR) before and five minutes after medication. Asthma symptoms as well as adverse events were registered on diary cards. After each study period a questionnaire containing acceptability questions was completed. At the end of the study the patients indicated their preference for one of the two treatments. The two treatments were equal concerning bronchodilation and asthma symptoms. There was an overall preference for the Bricanyl Turbuhaler.

[Oxygen conserving nasal catheters. Oxymizer pendant]. / Oksygensparende nesekateter. Oxymizer pendant.

The Oxymizer pendant consists of a 40 ml pendulating reservoir bag which is connected to the prongs by two tubes. Both reservoir and tubes serve as oxygen reservoirs. We wanted to examine if it was possible to save oxygen by changing from the usual nasal cannula to Oxymizer pendant. 11 patients with hypoxaemia due to chronic obstructive pulmonary disease were examined. We were able to reduce the oxygen requirement by approximately 65% without significant changes in SaO2. All 11 patients evaluated the Oxymizer pendant to be more comfortable than the usual nasal cannula.

Bambuterol: a new long acting bronchodilating prodrug.

Bambuterol, a carbamate prodrug of terbutaline as a 5, 10, or 20-mg tablet, was given once every evening to patients with asthma in a randomized double-blind crossover study. Twenty milligrams improved pulmonary functions over 24 hours; 5 and 10 mg did not. Few side effects were observed.

Comparison between theophylline and an adenosine non-blocking xanthine in acute asthma.

Enprofylline, a drug without adenosine antagonism and theophylline, a potent adenosine antagonist, were compared, double-blind, randomized, in acute asthma (n = 33). The drugs were given intravenously as loading over 10 min followed by maintenance infusion for 24 h. Mean final plasma levels were very high with enprofylline (14 mg.l), and larger than calculated with theophylline (16 mg.l). Seven patients had maximum levels of enprofylline ranging between 16 and 42 mg.l. Extreme plasma levels of enprofylline were not associated with any theophylline-like central nervous system excitatory effects related to seizure-inducing ability. Some irregularities in the heart rhythm did not raise clinical problems and no significant difference between enprofylline and theophylline was recorded. At 1 h patients on enprofylline (mean plasma level: 5.7 mg.l) and theophylline (12.2 mg.l) had improved their peak expiratory flow rates by 31% and 15% (p less than 0.05), respectively. The improvement in lung function after 24 hours did not differ between treatments suggesting that the high levels of enprofylline were supramaximal for its anti-asthma effects in this situation. In conclusion, with enprofylline it is demonstrated that an adenosine non-blocking xanthine derivative may lack CNS-excitatory effects, but be more potent than theophylline in the treatment of acute asthma.

Stabilization of a diluted aqueous mite allergen preparation by addition of human serum albumin. An intracutaneous test study.

Stability of diluted Spectralgen Dermatophagoides farinae allergen preparations in phenol-saline with, and without human serum albumin (HSA) has been studied by intracutaneous tests in mite-allergic patients. The phenol-saline reconstituted mite allergen preparation lost activity to less than 1/10 of initial activity within 1 week, while mite allergen preparation reconstituted with solvent containing HSA was stable for at least 8 months after reconstitution. Human serum albumin probably prevents adsorption of allergens to glass surfaces which may be a problem for very diluted allergen preparations.

The effect of a new anti-allergic drug ICI 74, 9I7, given by aerosol, on nasal stenosis induced by allergen.

Nasal airways resistance was measured in ten patients with allergic rhinitis during intranasal application of an extract of grass pollen. Pretreatment with placebo did not inhibit the increase in nasal airways resistance, whereas ICI 74,917 administered from a pressurized aerosol gave almost complete protection. ICI 74,917 was well tolerated and no evidence was obtained of local hyposensitization during the period of the study.

Effect of atenolol on ventilatory and cardiac function in asthma.

The effects on ventilatory and cardiac function of atenolol, a new cardioselective beta-adrenoceptor blocking agent, were compared with those of practolol in a double-blind trial in 12 patients with asthma. Both drugs impaired ventilatory function--atenolol insignificantly and practolol significantly. Atenolol was if anything more cardioselective than practolol. Neither drug interfered significantly with the bronchodilator response to inhaled isoprenaline. Atenolol is suitable for use in patients for whom practolol would formerly have been chosen because of its cardioselectivity.

Beta1-blocker (practolol) and exercise in patients with chronic obstructive lung disease.

Ventilatory and circulatory data from 20 patients suffering from chronic obstructive lung disease have been obtained before, during and after exercise at 600 kpm/min for 5 min on a bicycle ergometer. The patients had been given intravenously practolol, 15 mg, or saline alternatively, using a double-blind cross-over technique. A slight postexercise reduction of FEV1 (8%) was noted after practolol medication as compared to placebo, with an accompanying decrease in PaCO2; PaO2 did not differ substantially. No wheezing or inappropriate dyspnea attributable to the medication was noted in any of the patients. The well known beta1-blocking effects on the circulation were confirmed, with maintained Q and reduced HR, together with a lowered systemic BP during and after exercise. There was a significant positive relationship between the postexercise reduction of FEV1 and the concomitant fall in HR. It is concluded that practolol in doses with near maximal circulatory effects had a slight, but clinically insignificant effect on the ventilatory parameters.

The effect of beclomethasone dipropionate aerosol on allergen induced nasal stenosis.

Nasal resistance to air flow has been used to evaluate the effect of beclomethasone dipropionate aerosol on allergen induced nasal stenosis. Sixteen patients with allergic rhinitis due to pollen were investigated in a randomized double-blind cross-over study with beclomethasone dipropionate aerosol and placebo aerosol. Only patients reacting to challenge were chosen. The study was carried out in the pollen-free season. After 1 week on either active or placebo aerosol a basic resistance value was determined followed by allergen challenge. Nasal resistance was determined 15 min and 7 hr after challenge. The aerosols were changed and after another week the procedure was repeated. There was significant preference (P less than 0.01) for beclomethasone dipropionate aerosol.