Kneubühler H R, Kyd K, Benoit R C, Scherrer M
Schweiz Med Wochenschr. 1980 May 24;110(21):812-6.
Oxitropium bromide (Ba 253, Boehringer, Ingelheim) is a scopolamine-like atropine derivate with a mode of action approximating to that of ipratropium bromide (Atrovent, Sch 1000). The peak effect and duration of bronchodilatation with oxitropium bromide appears to be better than that of ipratropium bromide. Fifteen patients with a stable chronic bronchial obstruction were investigated in a double blind cross-over study. The obstruction was partially reversible by beta-stimulation. The patients inhaled 0.2 mg oxitropium bromide or placebo at 9.30 p.m. after two controls of FEV1 at 9 p.m. and 9.15 p.m. We re-examined the patients at 7 a.m. and 7.15 a.m. the following day and observed a significant parasympathetic additional obstruction under placebo, whereas, under the medication with oxitropium bromide overnight, significant bronchodilation was observable. When 0.2 mg oxitropium bromide was given at 7.30 a.m. to all patients, those pretreated with placebo showed significantly better bronchodilation than those pretreated with oxitropium bromide. It is concluded that oxitropium bromide is a long-acting (10 hours) overnight bronchodilator. The bronchodilation is probably due to prolonged parasympathicolysis in the airways.
氧托溴铵(Ba 253,勃林格殷格翰公司)是一种类似东莨菪碱的阿托品衍生物,其作用方式与异丙托溴铵(爱全乐,Sch 1000)相近。氧托溴铵的支气管扩张峰值效应和持续时间似乎优于异丙托溴铵。在一项双盲交叉研究中,对15例稳定期慢性支气管阻塞患者进行了调查。阻塞可通过β受体激动剂部分逆转。患者在晚上9点和9点15分对第一秒用力呼气量(FEV1)进行两次测量后,于晚上9点30分吸入0.2毫克氧托溴铵或安慰剂。次日上午7点和7点15分对患者进行复查,结果发现在使用安慰剂时存在显著的副交感神经附加阻塞,而在夜间使用氧托溴铵治疗时,可观察到显著的支气管扩张。当上午7点30分给所有患者服用0.2毫克氧托溴铵时,预先使用安慰剂治疗的患者支气管扩张效果明显优于预先使用氧托溴铵治疗的患者。结论是,氧托溴铵是一种长效(10小时)夜间支气管扩张剂。支气管扩张可能是由于气道内副交感神经阻滞时间延长所致。