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Biomedical subjects

P Dorow

Publications and source records attributed to P Dorow.

At least 55 records · Page 3Linked to original sources
PubMed1990

Mucolytics: when dispensable, when necessary?

Many patients with chest disease have difficulty in clearing their chests of sputum. A variety of substances have been used in an attempt to help them. Mucolytic drugs can alter the rheological properties of mucus by acting directly on the secretions or by modifying the metabolic activity of the mucus secreting cells. Many physicians and patients are certain to reap a benefit. This paper will discuss the effectiveness of mucolytic therapy.

Acetylcysteine↗
PubMed1990

Long-term treatment of angina pectoris with bisoprolol or atenolol in patients with chronic obstructive bronchitis: a randomized, double-blind crossover study.

Forty outpatients suffering from angina pectoris due to coronary artery disease and concomitant reversible. chronic obstructive bronchitis were treated with the beta1-selective beta-blockers atenolol (50 mg) and bisoprolol (5 mg) for 6 months in each case, following a randomized, double-blind crossover study design. Lung function tests were carried out by means of whole-body plethysmography before and then several times during treatment. 2 to 4 h after drug intake (once daily in the morning). The main target variables for the factorial analysis of variance for comparison of the two beta-blockers were the airway resistance (AWR), the forced expiratory volume in the first second (FEV1), and the peak expiratory flow rate (PEFR). Bicycle ergometry was performed before and after therapy in order to check the cardiovascular effects of the two beta-blockers. The patients were questioned as to their angina pectoris and bronchitis symptoms at the monthly check-ups. There was no difference between the two beta-blockers (p > 0.05), both causing a slight increase in AWR, which increased with therapy duration, and a small but significant decrease in FEV1 and PEFR (p < 0.01). The bronchitis symptoms were not affected; however, seasonal influences were detected. Atenolol and bisoprolol had comparably pronounced effects on the cardiovascular parameters during ergometry (blood pressure, heart rate, W x min product, and ST-segment depression) and the frequency of angina pectoris attacks. Even beta1-selective beta-blockers may cause an impairment of lung function in patients with chronic obstructive bronchitis. This may be due to the presence of beta1-adrenoceptors in the bronchial tissue. Fifty milligrams of atenolol and 5 mg of bisoprolol once per day are effective in the treatment of angina pectoris.

Adrenergic beta-1 Receptor Antagonists↗
PubMed1989

Safety and efficacy of cefixime versus cefaclor in respiratory tract infections.

A randomized controlled study design was used to compare the efficacy of cefixime versus cefaclor in 30 patients suffering from lower respiratory tract infections. Patients were treated with a 10 to 11 day course of cefixime 200 mg b.i.d. or cefaclor 500 mg t.i.d. The overall clinical response (cured and improved) in the 13 evaluable patients of the cefixime group was 100%. 12 of the 14 patients of the cefaclor group were cured or improved. In the two other patients the symptoms remained unchanged. The bacteriological efficacy in both groups was comparable. Adverse effects were not reported during the study.

Adult↗
PubMed1988

Celiprolol--review of airways studies.

Celiprolol was compared with chlorthalidone in a double-blind randomized placebo-controlled study of 30 hypertensive or anginal patients with reversible bronchial obstruction. The study consisted of a 4-week placebo run-in period and a 12-week titration period during which the dose of both drugs was increased at 4-week intervals if blood pressure was not reduced adequately. The doses of celiprolol were 200, 400 or 600 mg once daily, whereas those for chlorthalidone were 12.5, 25 or 37.5 mg once daily. Entry criteria were a diastolic blood pressure between 90 to 115 mm Hg, forced expiratory volume in 1 second between 40 and 80% of predicted value, increasing by 15% or more after salbutamol inhalation and the need for occasional bronchodilator therapy. Prophylactic medication for asthma was given at a constant dosage for 1 month before the study and throughout the study. Clinical variables were not significantly changed by either drug, and neither celiprolol nor chlorthalidone had any significant effect on forced expiratory volume in 1 second.

Antihypertensive Agents↗
PubMed1988

Bronchoneutral effects in hypertensive asthmatics--celiprolol versus chlorthalidone.

The actions of celiprolol and chlorthalidone on lung function were studied in a randomized double-blind study of 30 patients. At the end of a 4-week placebo run-in period each patient had a supine diastolic blood pressure between 90 and 115 mmHg, and a forced expiratory volume at the first second of expiration (FEV1) 50-80% of the predicted value in patients with bronchial asthma, and between 40% and 70% of the predicted value in patients with chronic airways obstruction. The active treatment period lasted 12 weeks during which patients received either celiprolol, 200-600 mg daily, or chlorthalidone 12.5-37.5 mg daily. Lung function, blood pressure and heart rate were measured and assessed every 2 weeks during active treatment. Systolic and diastolic blood pressures were reduced during treatment with both drugs, but FEV1, forced vital capacity and forced expiratory volume at 25-75% of vital capacity were not significantly altered. These results suggest that celiprolol does not adversely affect pulmonary function in hypertensive patients who also have chronic bronchial obstruction.

Antihypertensive Agents↗
PubMed1988

[Modification of mucociliary clearance by a combination of theophylline with ambroxol and of ambroxol in monotherapy].

Influence on Mucociliary Clearance by a Theophylline-Ambroxol Combination and by Ambroxol in Monotherapy. In a controlled randomised double-blind study the influence of theophylline + ambroxol (TA) and ambroxol (A) on lung function and mucociliary clearance was investigated. 19 patients with chronic obstructive lung disease were treated after a 5-day wash-out period for 5 days with TA (700 mg theophylline, 60 mg ambroxol/d) or A (60 mg ambroxol/d), respectively. Measurements were done on the 5th and 10th day. Under the treatment with TA a marked improvement of lung function was observed. The mucociliary clearance improved under treatment with TA and A, with TA being significantly better compared with treatment group A.

Adult↗
PubMed1987

[Treatment with betaxolol and placebo eyedrops in patients with glaucoma and reactive airway diseases].

The study communicated here was designed to evaluate the absence of pulmonary beta-blockade as detected by a histamine provocation in betaxolol-treated patients suffering from open-angle glaucoma and coexisting obstructive airway disease. The study was a randomized, double-masked crossover trial, comparing betaxolol 0.5% ophthalmic solution and placebo. Ten patients (4 male, 6 female) were eligible by demonstrating baseline off-therapy IOP values exceeding 22 mmHg and a FEV1 value that was reduced by 15% to 20% following histamine provocation. After an appropriate washout period, baseline IOP and pulmonary function (FEV1, FVC) were tested. One drop of test medication (betaxolol or placebo) was instilled in both eyes; tonometry and a pulmonary function test were performed 90 minutes later. The patients then underwent a histamine provocation test. The concentration of histamine necessary to reduce FEV1 and FVC by 15% to 20% was recorded. The IOP was significantly reduced in patients treated with betaxolol, but not in those given placebo. FEV1 and FVC values 90 minutes after treatment with betaxolol or placebo were not significantly different from baseline values. After histamine provocation the FEV1 was, as expected, significantly decreased from baseline (15% to 20%) in both treatment groups. There was no statistical difference in the histamine concentration necessary to reduce the FEV1 by 15% to 20% between placebo (5.60 mg/ml) and betaxolol (5.25 mg/ml) treatments. This demonstrates that betaxolol has no pulmonary beta-blocking effect. Our study suggests that ophthalmic treatment with betaxolol in patients with glaucoma and obstructive airway disease enhances pulmonary safety due to the beta-1 cardioselective action of the drug.

Adrenergic beta-Antagonists↗
PubMed1987

Therapeutic advantage of unequal dosing of theophylline in patients with nocturnal asthma.

Two theophylline treatments were compared in a randomized, multiple-dose, crossover study on 20 patients present with nonallergic bronchial asthma. Both products (E = Euphyllin CR, A = Afonilum Retard) were capsules containing micropellets. They were administered according to the recommendations of the manufactures and differed in the total daily theophylline dose (642 mg versus 500 mg), the partition of this dose (1/3 in the morning and 2/3 in the evening versus equal amounts in the morning and evening) and the timing of the evening dose (2200 hr versus 2000 hr). The patients were off oral theophyllines at least 2 days prior to study onset and no other drugs were allowed to be administered during the testing periods. On the 4th day of each study period, serum theophylline concentrations (STC) and peak expiratory flow rate (PEF) were determined every 2 hr. Compared with the 24-hr PEF reference profile taken prior to study onset, both theophylline treatments produced a significantly higher 24-hr PEF average (mesor). Treatment E resulted in significantly higher mesor than A; in addition, the PEF amplitude relative to the mesor was reduced by treatment E when compared with placebo.

Adult↗
PubMed1987

[Effect of different beta-receptor blockers on the respiratory function of patients with chronic obstructive pulmonary disease and arterial hypertension].

20 patients with confirmed diagnoses of arterial hypertension and chronic obstructive pulmonary disease were studied. Groups of 10 patients each were treated with propranolol 2 X 40 mg p.o. or betaxolol (Kerlone) 20 mg p.o., respectively. Pulmonary function, blood pressure and heart rate were assessed before and at 2, 4 and 6 h after administration of the first tablet on day 1 of the study. The same parameters were recorded 2 h after ingestion of the morning dose on each of the following days. Both drugs caused comparable significant decreases in blood pressure and heart rate on the 1st day of treatment. Propranolol was associated with a documented increase in the degree of bronchial obstruction.

Adrenergic beta-Antagonists↗
PubMed1987

[Effect of a secretolytic and a combination of pinene, limonene and cineole on mucociliary clearance in patients with chronic obstructive pulmonary disease].

Effect of a Secretolytic and a Combination of Pinene, Limonene and Cineole on Mucociliary Clearance in Patients with Chronic Pulmonary Obstruction. Studies demonstrating the elimination of radioactive particles during a 7-day course of therapy with 3 x 30 mg ambroxol or 4 x 1 capsule. Gelomyrtol forte (1 capsule = 0.3 g Myrtol, standardised to at least 20 mg of alpha-pinene, 75 mg of limonene and 75 mg of cineole (eucalyptol) yield improved mucociliary clearance in both groups. No change of lung function was observed.

Adult↗
PubMed1986

Bopindolol, pindolol, and atenolol in patients with chronic obstructive lung disease.

Twelve subjects with chronic obstructive lung disease and a partially reversible obstruction received increasing single doses of bopindolol (1, 2, 4, and 8 mg), pindolol (7.5, 15, and 30 mg), and atenolol (50 and 100 mg). Resting heart rate and blood pressure were reduced in a dose-dependent fashion. The actions of the drugs on lung function were assessed by whole body plethysmography. Pindolol did not influence mean airway resistance (Raw). Bopindolol (1, 2 and 4 mg) and atenolol (50 mg) exhibited a neutral effect on mean Raw. Atenolol (100 mg) and to a lesser extent bopindolol (8 mg) induced a long-lasting increase in mean Raw.

Adrenergic beta-Antagonists↗
PubMed1986

Effects of single oral doses of bisoprolol and atenolol on airway function in nonasthmatic chronic obstructive lung disease and angina pectoris.

A randomized, placebo-controlled, double-blind crossover investigation in 12 patients with non-asthmatic chronic obstructive lung disease and co-existing stable angina pectoris was done to compare two beta 1-selective adrenoceptor blocking agents, atenolol 100 mg and bisoprolol 20 mg. Systolic and diastolic blood pressures (SBP, DBP), heart rate (HR) as well as airway resistance (AWR, and less frequently forced expiratory volume in 1 s (FEV1) and intrathoracic gas volume (ITGV) were measured in the sitting position before and at various times up to 24 h after drug intake. During the first 4 h both beta-blockers produced a significant reduction in HR in comparison to placebo (p less than 0.01). Atenolol 100 mg significantly increased AWR relative to placebo and bisoprolol (p less than 0.05). After 24 h, a significant reduction in HR (p less than 0.01) could only be demonstrated after bisoprolol, whereas atenolol alone led to a significant elevation in AWR relative to placebo and bisoprolol (p less than 0.05) at that time. It is concluded that bisoprolol appears to have a high degree of beta 1-selectivity, thus providing a wide split between beta 1- and beta 2-adrenoceptor blockade. Bisoprolol in its therapeutic dose range is expected to be relatively safe as regards bronchoconstriction in patients suffering both from hypertension and/or angina pectoris and chronic obstructive lung disease.

Adrenergic beta-Antagonists↗
PubMed1986

[Chronic obstructive respiration disorders imaged by inhalation scintigraphy. Differential diagnosis and early detection using radio-aerosols].

Inhalation radioaerosol lung imaging was performed in 86 patients with chronic obstructive lung disease (COLD) and in 45 asymptomatic smokers with small airways dysfunction. Within certain limits analysis of abnormal aerosol scans helped distinguish emphysematous from brochitic and asthmatic types of disease. Patients with asthma often responded to bronchodilator treatment and abnormal aerosol images reverted to near normal patterns. Besides a slight aerosol distribution inhomogeneity in the lung periphery, patients with small airways dysfunction showed significant hypodeposition of inhaled particles distal to the ciliated airways. Compared with small airways dysfunction, COLD was associated with an even more decreased aerosol penetrance to the alveoli.

Adult↗
PubMed1986

[Therapeutic consequences of glaucoma treatment with different beta blockers in patients with obstructive respiratory tract diseases].

In patients in whom chronic obstructive bronchial disease and chronic glaucoma had been diagnosed, the most important ventilation parameters and intraocular pressures were investigated in a double-blind cross-over study. The airway resistance, the forced expiratory volume within the first second, the thoracic volume, and the mean expiratory flow in these patients exhibited significant differences after treatment with non-cardioselective beta-blocking agents, depending on the beta-receptor stimulating action of this ophthalmic solution (Pindolol 1% eye drops) or without any intrinsic sympathicomimetic action (Metipranolol 0.6% eye drops). There was no fundamental difference in the intraocular pressure-lowering effect of these two locally applied beta-blocking solutions. This study implies that when selecting a beta-blocking ophthalmic solution for anti-glaucoma treatment, the existence of an ISA effect of these eye drops is relevant only to avoid systemic side effects such as bronchopulmonary obstruction.

Adrenergic beta-Antagonists↗
PubMed1986

A comparison of celiprolol and chlorthalidone in hypertensive patients with reversible bronchial obstruction.

The objective of this study was to evaluate the effects of celiprolol, a new beta-blocking drug, on the clinical condition and pulmonary function of hypertensive patients with reversible bronchial obstruction. Celiprolol was compared with chlorthalidone, an antihypertensive drug without known effect on bronchial tone. The study consisted of a 4-week placebo run-in period and a 12-week titration period in which the dose of both drugs was increased at 4-week intervals if blood pressure was not reduced adequately. The doses of celiprolol were 200, 400, or 600 mg once daily; those for chlorthalidone 12.5, 25, or 37.5 mg once daily. Entry criteria were a diastolic blood pressure between 90 and 115 mg Hg, and FEV-1 between 40% and 80% of predicted value, increasing by 15% or more after salbutamol, and a need for occasional bronchodilator therapy. Prophylactic medication for asthma was given in constant dosage for a month before the study and throughout the study. Preliminary results on 66 patients demonstrate that neither drug had a clinically significant effect on FEV-1, FEF 25-75, or FVC. Clinical variables were not significantly changed by either drug: the average monthly asthma attacks fell from 18 to 13 with celiprolol and from 11 to 7 with chlorthalidone. FEF was reduced by more than 50% in two patients on celiprolol and three on chlorthalidone. Monthly asthma attacks increased by more than 100% in five patients on celiprolol and four on chlorthalidone. Thus, preliminary results are unable to demonstrate adverse effects from celiprolol in patients with asthma and hypertension.

Adrenergic beta-Antagonists↗
PubMed1986

Bopindolol, pindolol, and atenolol in patients with chronic obstructive lung disease.

Twelve subjects with chronic obstructive lung disease and a partially reversible obstruction received increasing single doses (1, 2, 4, and 8 mg) of bopindolol, (a new beta 1- and beta 2-adrenoceptor blocking drug with intrinsic sympathomimetic activity), pindolol (7.5, 15, and 30 mg), and atenolol (50 and 100 mg). The actions of the drugs on lung function were assessed by whole-body plethysmography. Pindolol did not influence mean airway resistance (Raw). Bopindolol 1, 2, and 4 mg and atenolol 50 mg also exhibited a neutral effect on mean Raw. Atenolol 100 mg, however, induced a long-lasting increase in mean Raw, which was to a lesser extent the case with bopindolol 8 mg. Six of the 12 subjects tested reacted more sensibly. Increases in Raw of more than 10% were observed with bopindolol 2 mg (1 subject), bopindolol 4 mg (4 subjects), pindolol 30 mg (3 subjects), and atenolol 50 mg (3 subjects). This clearly points toward a potential risk of eventually developing severe bronchospasm with each type of beta-adrenoceptor blocking drug in patients with chronic obstructive lung disease and a reversible component of the bronchial obstruction. Nevertheless it is concluded that beta-adrenoceptor blocking drugs with intrinsic sympathomimetic activity such as bopindolol and pindolol compare favorably with cardioselective agents such as atenolol.

Adrenergic beta-Antagonists↗