Bronchodilation and beta 2-selectivity of broxaterol in asthmatics: a crossover, single-blind, terbutaline- and placebo-controlled study.

To investigate the beta 2-receptor selectivity of a new beta 2-adrenoceptor agonist, broxaterol, we compared the respiratory and cardiovascular effects of this compound with those of terbutaline and placebo. Twelve asthmatic patients were evaluated in a randomized, single blind, crossover study. A single dose of each study treatment (broxaterol 400 micrograms and terbutaline 500 micrograms was administered with metered dose inhalers. Measurements of lung function (vital capacity, forced expiratory volume in one second, airway resistance and specific airway conductance), heart rate and systolic/diastolic blood pressure were performed before and at 15, 30, 60, 120, 240 and 360 min after each study treatment. No significant difference was observed between broxaterol and terbutaline in VC, FEV1 and Raw changes, although a greater and significant increase in sGaw was found only with broxaterol. Significant increases in heart rate and systolic blood pressure were observed only with terbutaline. The results of this study suggest that broxaterol can promote a greater bronchodilator effect with less cardiovascular side effects than terbutaline, probably through a greater beta 2-receptor selectivity.

Negligible metabolic effects of long-term oral treatment with a new beta 2-agonist: broxaterol.

Drugs that stimulate adrenergic receptors are expected to affect glucose and lipid metabolism. Therefore, it was deemed to be of interest to assess whether the new selective beta 2-adrenoceptor agonist, broxaterol, exerts any metabolic effect. Broxaterol has been evaluated in 21 patients, 18 men and 3 women, aged 34 to 80 years, with a diagnosis of reversible obstructive airways disease. Broxaterol was administered orally at doses of 0.5 mg thrice daily for 1-12 months, according to an open design. In addition to metabolic parameters (plasma glucose, insulin, high and low density lipoprotein-cholesterol, triglycerides, free fatty acids, glycerol, sodium, potassium), arterial pH, partial arterial oxygen and carbon dioxide pressure, lung function tests--forced expiratory volume in one second (FEV1), maximum mid-expiratory flow (MMEF75-25) and specific airways conductance (SGaw)--heart rate and blood pressure were assessed at baseline and after 1, 2, 3, 4, 5, 6, 9, 12 months of treatment. No statistically significant change from baseline was observed in the levels of plasma glucose, cholesterol, triglycerides, or free fatty acids. Plasma levels of insulin, glycerol and sodium only increased in the first three months of treatment; a slight hypokalaemia was also observed during the same period. The bronchodilation (significant increase in FEV1, MMEF75-25, SGaw) was maintained throughout the study; no hospital admission was necessary. Tremor, palpitations and restlessness were reported in six patients; no significant changes in heart rate and blood pressure were observed. The data suggest that the metabolic effects of long-term treatment with oral broxaterol can be considered as very negligible.

Duovent compared to carbuterol in the treatment of bronchospasm.

Fourteen patients with chronic obstructive lung disease (COLD) were studied. All were in a relatively stable clinico-functional state, and bronchospasm was reversible with fenoterol. The study was carried out over 3 days. Duovent and Carbuterol were given at random on the 1st or 3rd day to each patient; the placebo was always given on the 2nd day. Each drug was administered with 2 puffs of a metered-dose aerosol, corresponding to 200 micrograms fenoterol + 80 micrograms ipratropium bromide for Duovent and 200 micrograms of active substance for Carbuterol. The patients were studied for 7 h after administration of the 3 preparations. Ventilatory and cardiocirculatory parameters as well as local and systemic tolerance of the drugs were evaluated. The data show that Douvent has a more rapid and powerful bronchodilator action compared to Carbuterol. The action of Duovent is more constant and prolonged compared to the other drug and acts on both proximal and distal airways. Local and systemic tolerance is excellent for both drugs studied. In conclusion, Duovent is a rational and effective combination in the treatment of bronchospasm.

[Survival curves of 169 cases of primary lung cancer]. / Studio delle curve di sopravvivenza in 169 casi di cancro primitivo del polmone.

169 lung cancer patients were studied and their survival curves analysed after classification according to various parameters (clinical stage using the TNM method, histological type, and morphoradiological type). The resulting tragic picture is further confirmation of the primary importance of prompt diagnosis as well as an appropriate prevention strategy.

[Treatment of chronic respiratory insufficiency of pulmonary origin. Clinical considerations]. / La terapia dell'insufficienza respiratoria cronica pneumogena. Considerazioni cliniche.

The key-points of the physiopathological treatment of chronic pneumogenous respiratory insufficiency are: correction of distribution defects, suitable local adjustment of the ventilation: perfusion ratio, and correction of obstacles to alveolocapillary diffusion. Many drugs can be used to obtain these results; bronchodilators, vasoactive drugs, cortisones, cardiokinetics, antibiotics, analeptics. Reference is also made to oxygen therapy, depletion management (bloodletting and-or diuretics, and their possible mechanisms. Lastly, attention is given to disturbances, in acid-base equilibrium in chronic respiratory insufficiency and their correction.