Borum S, Becker B, Mygind N, Borum P
Department of Otorhinolaryngology, Glostrup Hospital, Copenhagen, Denmark.
Rhinology. 1996 Dec;34(4):198-200.
Topical application of the anti-cholinergic drug ipratropium bromide is used for the treatment of rhinorrhoea. As the commercially-available pressurized aerosols are now largely being replaced by aqueous pump sprays, not containing CFC gases, we have compared these two types of sprays in a time-effect study of 20 normal persons, using the secretory response to nasal methacholine challenge as the effect parameter. Pre-treatment has been given as a single dose of 80 mg of ipratropium bromide, and 24 mg methacholine was used for challenge. The pressurized aerosol reduces rhinorrhoea with 60% (p < 0.05) and the effect lasts for at least 8 h. The corresponding value for the aqueous pump spray is 40% (p < 0.05) and the effect lasts for less than 4 h. The differences between the two sprays is significant 30 min, 1, 2 and 4 h after medication (p < 0.05). This finding is unexpected and we cannot offer a satisfactory explanation. The result indicates that changes in dosing and dose-frequency of ipratropium bromide may be necessary when patients are transferred from a pressurized spray to an aqueous pump spray.
抗胆碱能药物异丙托溴铵的局部应用用于治疗鼻漏。由于目前市售的加压气雾剂在很大程度上正被不含氯氟烃气体的水性泵喷雾剂所取代，我们在一项对20名正常人的时效研究中比较了这两种喷雾剂，以对鼻内乙酰甲胆碱激发的分泌反应作为效应参数。预处理给予单剂量80毫克异丙托溴铵，激发时使用24毫克乙酰甲胆碱。加压气雾剂可使鼻漏减少60%（p<0.05），且效果持续至少8小时。水性泵喷雾剂的相应数值为40%（p<0.05），效果持续不到4小时。两种喷雾剂之间的差异在用药后30分钟、1小时、2小时和4小时具有显著性（p<0.05）。这一发现出乎意料，我们无法给出令人满意的解释。结果表明，当患者从加压喷雾剂转换为水性泵喷雾剂时，可能需要改变异丙托溴铵的给药剂量和给药频率。
