Effects of a Single Dose Inhalation of Ipratropium Bromide, Salbutamol, Salmeterol, Beclomethasone, Budesonide in Stable Chronic Bronchitis: Comparative Study

Abstract

Chronic bronchitis usually treated with long acting bronchodilators and inhaled corticosteroids as monotherapy or in combination. The aim of this study is to assess the efficacy of single dose of β2-agonist (short and long acting), muscarinic antagonist and inhaled corticosteroids on the pulmonary function test in clinically stable chronic bronchitis patients. A total number of 93 (61 males and 32 females) patients who fulfilled the criteria of uncomplicated chronic bronchitis were assessed. Single inhaler dose of salbutamol (100 µg), salmeterol (50 µg), ipratropium bromide (20 µg), beclomethasone treatment (250 µg) or budesonide treatment (200 µg) was administered. Pulmonary function test using spirometry was assessed over 30 min. Pulmonary function determinants included: Forced expiratory volume in the first second (FEV₁: predicted and actual), Forced vital capacity (FVC: predicted and actual), Peak expiratory flow rate (PEFR) and Respiratory rate (RR). These determinants were electronically determined per body surface area. Salbutamol did not produce significant changes in FEV₁, FVC and PEFR whereas salmetrol significantly improved the FVC by 31.2% increment. Ipratropium bromide improved FEV₁, FVC and PEFR by 27.8, 20 and 26.3% respectively. Beclomethasone inhaler significantly improved the FEV₁, FVC and PEFR by 38.1, 25.3, 24.37 and 17.2% respectively after 30 min. On the other hand, budesonide significantly improved PEFR by 29.5% after 30 min. It concludes that single dose inhaler of muscarinic antagonists or corticosteroid offers superior beneficial effect than β2-agonists (short or long acting) in stable chronic bronchitis.

Keywords: Chronic bronchitis, inhalers, pulmonary function test.