Nasal disorders and anticholinergic therapy.

Treatment of patients with perennial rhinitis, common cold and watery nasal hypersecretion, is still unsatisfactory. As the glands are innervated by parasympathetic nerves we examined the effect of intranasal application of a parasympatholytic drug, ipratropium bromide. In the laboratory we have studied the effect, dosage and duration of ipratropium in normal subjects. These investigations showed a strong inhibition of the secretion from the nasal glands for more than 6 hours in a dosage regimen with no local or systemic adverse effects. We continued in a placebo-controlled clinical short term study and an open long term study on patients with perennial rhinitis. Furthermore we conducted a clinical trial in patients with common cold. We found an effect on watery hypersecretion in all these patient groups. Several laboratory and clinical studies have since confirmed our results. Ipratropium inhibits the reflectory watery secretion from the nasal glands, but does not change the basal secretion rate. The onset of action is rapid and the effect is prolonged. Long term treatment is safe and may possibly have a curative effect in some patients.