Anderson W M
Am J Med. 1986 Nov 14;81(5A):45-53. doi: 10.1016/0002-9343(86)90461-4.
Older anticholinergic agents such as stramonium and atropine have significant non-pulmonary effects. The non-pulmonary effects of a new quaternary anticholinergic, ipratropium bromide, have been studied both in the United States and abroad; these effects include inhibition of salivation, interference with micturition, and ocular effects such as pupil size, visual acuity, and intraocular pressure. Hemodynamic effects such as heart rate, blood pressure, and blood gas changes have also been studied. These evaluations have been performed in animals and in healthy and sick human subjects, following administration of ipratropium parenterally and by inhalation in a variety of dosage ranges. Ipratropium, a muscarinic inhibitor, would be expected to have effects similar to those of atropine. The most conspicuous result of these studies has been the low incidence of significant changes, even at high dose levels, when ipratropium bromide is administered by inhalation.
较老的抗胆碱能药物，如曼陀罗和阿托品，具有显著的非肺部效应。一种新型季铵类抗胆碱能药物异丙托溴铵的非肺部效应已在美国和国外进行了研究；这些效应包括抑制唾液分泌、干扰排尿以及眼部效应，如瞳孔大小、视力和眼压。还研究了诸如心率、血压和血气变化等血流动力学效应。这些评估是在动物以及健康和患病的人类受试者中进行的，在各种剂量范围内通过肠胃外给药和吸入给予异丙托溴铵后进行。异丙托溴铵是一种毒蕈碱抑制剂，预计其作用与阿托品相似。这些研究最显著的结果是，当通过吸入给予溴化异丙托铵时，即使在高剂量水平，出现显著变化的发生率也很低。
