European Journal of Clinical Pharmacology

, Volume 32, Issue 4, pp 343–346 | Cite as

Airway response to salbutamol and to ipratropium bromide after non-selective and cardioselective beta-blocker

  • P. Desche
  • A. Cournot
  • J. Duchier
  • J. F. Prost
Originals

Summary

Eight healthy men were randomly assigned in a latin square order to receive single doses of placebo, tertatolol 5 mg, propranolol 80 mg and atenolol 100 mg at 7-day intervals. Resting heart rate and pulmonary function were measured 10 min before and over the 240 min following dosing, and then 15 min after inhalation of salbutamol 200 µg and ipratropium bromide 40 µg. The three beta-blockers caused similar reductions in resting heart rate throughout the study, whereas placebo had no effect. The three beta-blockers, like placebo, produced no significant change in pulmonary function during the 240 min after dosing. The bronchodilator response to salbutamol after atenolol and placebo was preserved, whereas it was reduced after administration of either of the non-selective beta-blockers, tertatolol and propranolol. An unequivocal response of the airways to ipratropium bromide was observed after tertatolol and propranolol, which was much greater than after atenolol. No response was observed after placebo. Thus, despite bronchial beta2-blockade, by non-selective beta-blockers, bronchodilatation was definitely produced by ipratropium bromide, confirming the predominant role of the parasympathetic system in the autonomic innervation of normal human airways.

Key words

tertatolol salbutamol ipratropium bromide respiratory effect beta-selectivity anticholinergic drug airways innervation cholinergic innervation 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Wilcox PG, Ahmad D, Darke AC, Parsons J, Carruthers SG (1986) Respiratory and cardiac effects of metoprolol and bevantolol in patients with asthma. Clin Pharmacol Ther 39: 29–34Google Scholar
  2. 2.
    Thiringer G, Svedmyr N (1976) Interaction of orally administered metoprolol, practolol and propranolol with isoprenaline in asthmatics. Eur J Clin Pharmacol 10: 163–170Google Scholar
  3. 3.
    Ellis ME, Sahay JN, Chatterjee SS, Cruickshank JM, Ellis SH (1981) Cardioselectivity of atenolol in asthmatic patients. Eur J Clin Pharmacol 21: 173–176Google Scholar
  4. 4.
    Boushey HA, Holtzman MJ, Sheller JR, Nadel JA (1980) Bronchial Hyperreactivity. Am Rev Respir Dis 121: 389–413Google Scholar
  5. 5.
    Grieco MH, Pierson RN Jr (1971). Mechanism of bronchoconstriction due to beta-adrenergic blockade. J Allergy Clin Immunol 48: 143–152Google Scholar
  6. 6.
    Paterson JW, Woolcock AJ, Shenfield GM (1979). Bronchodilator drugs. Am Rev Respir Dis 120: 1149–1188Google Scholar
  7. 7.
    Pakes GE, Brogden RN, Heel RC, Speight TM, Avery GS (1980) Ipratropium Bromide: A review of its pharmacological properties and therapeutic efficacy in asthma and chronic bronchitis. Drugs 20: 237–266Google Scholar
  8. 8.
    De Blasi A, Lipartiti M, Pirone F, Rochat C, Prost JF, Garattini S (1986) Reduction of beta-adrenergic receptors by tertatolol: An additional mechanism for beta-adrenergic blockade. Clin Pharmacol Ther 39: 245–254Google Scholar
  9. 9.
    European Community for Coal and Steel (1983) Standardized lung function testing. In: Quanjer PH (ed) Report Working Party “Standardization of Lung Function Tests”. Bull Eur Physiopathol Respir 19 [Suppl 5]: 1–95Google Scholar
  10. 10.
    Staveris S, Blaise P, Efthymiopoulos C, Schneider M, Jamet G, Jung L, Koffel JC (1985) Quantitative determination of tertatolol in biological fluids by gas chromatography-mas spectrometry. J Chromatogr 339: 97–103Google Scholar
  11. 11.
    Singh BN, Whitlock RML, Comber RH, Williams FH, Harris EA (1976) Effects of cardioselective beta-adrenoceptor blockade on specific airways resistance in normal subjects and in patients with bronchial asthma. Clin Pharmacol Ther 19: 493–501Google Scholar
  12. 12.
    Foley JE, Sigurdson MJ, Conliffe TF, Fand RS, Anthonisen NR (1982) Effects of cardioselective and nonselective beta-adrenergic antagonists on pulmonary mechanics. Clin Pharmacol Ther 32: 149–155Google Scholar
  13. 13.
    Warren JB, Monaghan AT, Clark TJH (1984) Effects of penbutolol and propranolol on normal airway response to salbutamol. Clin Pharmacol Ther 36: 47–50Google Scholar
  14. 14.
    Tattersfield AE, Cragg DJ, Bacon RJ (1984) Assessment of beta-adrenoceptor selectivity of a new beta-adrenoceptor antagonist, bisoprolol, in man. Br J Clin Pharmacol 18: 343–347Google Scholar
  15. 15.
    Gross NJ, Skorodin MS (1984) Anticholinergic, antimuscarinic bronchodilators. Am Rev Respir Dis 129: 856–870Google Scholar
  16. 16.
    Gross NJ, Skorodin MS (1984) Role of the parasympathetic system in airway obstruction due to emphysema. N Engl J Med 311: 421–425Google Scholar
  17. 17.
    Barnes PJ, Pride NB (1983) Dose-response curves to inhaled beta-adrenoceptor agonists in normal and asthmatic subjects. Br J Clin Pharmacol 15: 677–682Google Scholar
  18. 18.
    Ruffin RE, McIntyre ELM, Latimer KM, Ward HE, Crockett AJ, Alpers JH (1982). Assessment of beta-adrenoceptor antagonists in asthmatic patients. Br J Clin Pharmacol 13: 325S-335SGoogle Scholar

Copyright information

© Springer-Verlag 1987

Authors and Affiliations

  • P. Desche
    • 1
  • A. Cournot
    • 2
  • J. Duchier
    • 2
  • J. F. Prost
    • 3
  1. 1.Division of PneumologyHôpital FochSuresnesFrance
  2. 2.TherapharmParisFrance
  3. 3.Division of CardiologyInstitut de Recherches Internationales ServierNeuilly sur SeineFrance

Personalised recommendations