[Anticholinergic agents as bronchodilator agents. Significance of acetylcholine as a bronchoconstrictor transmitter agent in airway obstruction].
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Response in a bronchodilator must be expressed by the combining the largest amplitude of response with the highest reproducibility. The forced expiratory volume in the first second (FEV1) meets these conditions and thus represents the best test. The bronchodilator response is commonly expressed in percent of the initial FEV1. Through a mathematical bias, this method overestimates the response in the most severely obstructed subjects. Expressing the bronchodilator response in percent of predicted FEV1 eliminates this distortion and must be preferred.
General pharmacological properties of BD 40A, a new bronchodilator agent, were investigated and the following results were obtained. BD 40A showed no effect on the central nervous system, and little effect on the autonomic nervous system. BD 40A produced an increase in heart and respiration rates, a decrease in blood pressure, and change in ECG in both anesthetized dogs and conscious animals. These effects of BD 40A were inhibited by propranolol (beta-blocker) administration. BD 40A potentiated carbohydrate and lipid metabolism in Beagle dogs. The pharmacological profile of BD 40A was similar to that of hexoprenaline which was used as the reference compound.
The preparation of the four isomeric azaxanthones 3 and a number of their aromatic ring substituted derivatives is described. These ketones were converted into the title compounds which were examined for their biological properties. The most interesting compound in this series, the 1-methyl-4-piperidylidene derivative of 1-azaxanthene, shows the profile of an orally effective potent bronchodilating agent as well as a moderate antihistamine. Biological properties of this compound were compared to a number of antihistamines as well as known bronchodilating agents. Structure-activity relationships are also discussed.
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Two methods of measuring skeletal muscle tremor when evaluating this side-effect of treatment with bronchodilator agents are described. The first method, involving drawing a line between two sinus curves, is simple and requires no special equipment. Each time that the line crosses one of the sinus curves this is registered as an error. The large variation in results is a disadvantage but this drawing method can be used when more sophisticated devices are not available. Skeletal muscle tremor recorded with a Grass accelerometer gives accurate results provided the method is carefully standardized and the resting period adequate. The dose-response curves obtained during infusions of beta-adrenergic-stimulating drugs are linearly related to the dose given and are highly reproducible. The tremor ratio has the advantage over absolute values of smaller variations. The first of three 30-s periods registered gives the lowest tremor value and least variation, so this is the period used for analysis. Subjective experience of tremor is related to the Grass recording. In some cases, however, there is marked discrepancy between subjective and objective evaluation of tremor, which may be explained by the masking effect of concomitant heart stimulation. When tremor is related to heart rate in a single experiment a regression line is obtained. Another drug may give a different slope. The two slopes demonstrate the different selectivity of the drugs for the beta-receptors in the heart and skeletal muscle.
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LG 30435, a new quaternary derivative of the H1-histamine antagonist mequitazine, was evaluated against bronchospasm induced by different agonists. This compound inhibited equipotently methacholine- and histamine-induced contractions of isolated guinea-pig trachea. When administered to guinea-pig by the i.v. and/or the aerosol route, LG 30435 inhibited dose dependently the bronchospasm induced by acetylcholine and histamine and to a lesser degree that induced by 5-hydroxytryptamine and LTD4. When compared to that of mequitazine, its potency was higher in each case, up to 500-fold when tested in vitro against methacholine. LG 30435 also counteracted antigen-induced bronchospasm both in passively sensitized guinea-pigs and in actively sensitized rats. This compound had a rapid onset of action and an adequate duration after aerosol administration. It was poorly absorbed both by the oral and the aerosol routes and it did not appear to penetrate the blood-brain barrier. These results show that LG 30435 is a new aerosol bronchodilator agent, which, due to its multiple pharmacodynamic actions and to its suitable pharmacokinetics, is potentially useful in the therapy of obstructive airways disease.
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The action mechanism of the bronchodilator activity of BB-1502 was studied in comparison with aminophylline. Orally administered BB-1502 did not inhibit passive cutaneous anaphylaxis in rats, an immediate allergic reaction of Type I, but strongly protected the same antigen-mediated anaphylactic asthma by the intraduodenal route, the activity being approximately 13 times more potent than that of aminophylline. BB-1502 also inhibited IgG-mediated anaphylactic asthma in guinea pigs by the oral route. Both IgE- and IgG-mediated histamine releases from rat lung were similarly inhibited by BB-1502, the potency being 2--3 times that of aminophylline. Disodium cromoglycate showed specific inhibition of the IgE-mediated reaction. BB-1502 and aminophylline showed nonspecific inhibition of the spasms of guinea pig ileum elicited by histamine, acetylcholine and BaCl2. Both compounds inhibited cyclic AMP and cyclic GMP phosphodiesterases (PDEs) derived from guinea pig organs. BB-1502 specifically inhibited the cyclic AMP PDE of lung and brain origins, while aminophylline showed no such specificity. The results of the present study suggested that the bronchodilator and anti-asthmatic actions of BB-1502 might, at least in part, be due to the regulation of cyclic nucleotide PDEs.
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Two aerosolised bronchodilators, one sympathomimetic and one parasympatholytic, were tested either alone or in combination for their ability to improve the pulmonary function of double-muscled calves suffering from acute respiratory distress syndrome. In control animals treated with 0.9 per cent saline the parameters of pulmonary function and signs of clinical distress did not change significantly within the hour following the first treatment. Among the other animals, both at one hour and seven days after the first treatment, the most clinical improvement was observed in the animals treated with both bronchodilators and the least in the animals treated with clenbuterol hydrochloride. One hour after the first treatment the respiratory system compliance of the animals treated with ipratropium bromide and the arterial oxygen tension of the animals treated with both bronchodilators were significantly enhanced. After seven days the resistive parameters, the rectal temperature and the respiratory rate were also significantly improved in the animals treated with ipratropium bromide or both bronchodilators whereas only the respiratory rate and rectal temperature were significantly reduced in the animals treated with clenbuterol hydrochloride.
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