Bambuterol: effective in nocturnal asthma.

Bambuterol was compared with placebo in 28 patients with nocturnal asthma in a randomized, double-blind cross-over study. All patients were symptomatic despite taking inhaled beta 2-agonists, inhaled corticosteroids (in 26 patients the median daily dose was 1500 micrograms) and oral corticosteroids (in eight patients the median daily dose was 10 mg). Patients demonstrated > or = 20% overnight fall in peak expiratory flow (PEF) for at least half of the 14-day run-in period. They then entered two treatment periods lasting 14 days when bambuterol 20 mg nocte and placebo were given in random order. Compared to placebo, bambuterol produced a 16% improvement in mean PEF on waking (271 l min-1 vs. 239 l min-1 P = 0.0002) and a 10% improvement in evening PEF measured 24 h after drug intake (318 l min-1 vs. 296 l min-1 P = 0.01). Bambuterol significantly reduced frequency of nocturnal awakening from 1.1 to 0.7 per night (P = 0.01) and nocturnal beta 2-agonist use from 2.7 to 2.1 puffs (P = 0.0004). Other nocturnal symptoms: cough, wheeze and dyspnoea were also significantly reduced during bambuterol treatment and patients quality of sleep was improved. The results indicate bambuterol (20 mg nocte) provides effective nocturnal bronchodilation with sustained effect for 24 h and may have a useful therapeutic role in the control of symptomatic nocturnal asthma.

A comparison of effects of inhaling a combined preparation of fenoterol with ipratropium bromide (Duovent) with those of fenoterol and salbutamol.

The effects of inhaling an aerosol preparation containing fenoterol 200 micrograms and ipratropium bromide 80 micrograms were compared with those of inhaling 200 micrograms of salbutamol and a similar dose of fenoterol on 20 patients with chronic bronchitis and four patients with chronic stable asthma. The dose of each drug was contained in 2 puffs taken from a metered-dose inhaler. Changes in airways function were assessed by measuring peak expiratory flow rate. Pulse, blood pressure and presence of any tremor were monitored to detect drug-induced side effects. No significant difference was found in the onset of action and overall bronchodilator effects between the three drugs. The combined preparation was found to have a significantly greater bronchodilator action three and four hours after inhalation compared to the other two drugs. A significant effect lasting six hours was found with salbutamol and fenoterol, but the combined preparation had an effect which was significant up to seven hours. There was no significant difference in the side effects which were minimal for all three drugs.