Effect of four-week treatment with oxitropium bromide on lung mucociliary clearance in patients with chronic bronchitis or asthma.

The effect of oxitropium bromide on lung mucociliary clearance, pulmonary function and viscoelastic properties of sputum was investigated in 10 asthmatics and 10 chronic bronchitics. A controlled, double-blind, crossover study was performed. Following a baseline (B) measurement the patients were, in a random order, allocated placebo (P) or oxitropium bromide (O; 0.1 mg/puff), administered from metered dose inhalers, which they used for 4 weeks at a dose of 2 puffs t.d.s. This test medication was used in conjunction with their normal medication. At the end of the treatment period the patients were assessed, the treatments were then crossed over and a final assessment made 4 weeks later. The administration of oxitropium bromide resulted in (1) small but statistically significant increases in pulmonary function (less than 10% vs. placebo); (2) increased penetrance of radioaerosol into the lungs (mean +/- SEM alveolar deposition: 35 +/- 3, 26 +/- 3 and 24 +/- 3% for the O, P and B runs respectively; p less than 0.025); (3) no significant change in particle clearance rate from the lungs despite their deeper penetration (mean +/- SEM area under the tracheobronchial clearance curves between 0 and 6 h: 317 +/- 26, 324 +/- 25 and 287 +/- 25%.h for the O, P and B runs respectively; p greater than 0.1); (4) no alteration in sputum production, and (5) no significant changes in apparent viscosity (mean +/- SEM: 640 +/- 162, 446 +/- 79 and 557 +/- 115 mPa.s for the O, P and B runs, respectively; p greater than 0.1) and elasticity (mean +/- SEM: 3,682 +/- 1,383, 1,779 +/- 353 and 2,061 +/- 366 mPa for the O, P and B runs, respectively; p greater than 0.1) of sputum. When the two groups, i.e. the chronic bronchitics and asthmatics, were studied separately, no significant differences in any parameter measured (other than radioaerosol penetrance which was significantly enhanced on oxitropium bromide in chronic bronchitics) were noted between the three assessments.

The mucolytic effect of Sputolosin in horses with respiratory disease.

The effect of the mucolytic drug Sputolosin on the clinical signs of respiratory disease among 28 matched pairs of horses was examined. Compared with the untreated group, the treated group showed a significant decrease in the frequency of coughing and a decreased time to resolution of both cough and nasal discharge. The results indicate that the drug is potentially useful in the management of respiratory disease characterised by an abnormal or increased production of mucus.

Evaluation of a course for general practitioners on muscles and joints.

We attempted to evaluate a course on muscle and joint problems for general practitioners using a practice log diary and a factual test paper, which were completed both before and after the course by the doctors attending. A significant improvement was shown in the group score in the test paper taken after the course (p less than 0.001). Scores in the tests before and after had a negative correlation with age (p less than 0.001). In comparing the data in the second log diary with those in the first there was a significant reduction in the prescribing of drugs (p less than 0.001), use of heat treatment (p less than 0.001), and in "other" forms of treatment (p less than 0.01). No appreciable change in investigations or number of hospital referrals was shown. Those doctors who had low scores in the first factual test referred appreciably more patients to hospital and requested more x ray examinations (p less than 0.01).