Disease relevance of N-Isopropylatropine

• Patients with diabetes mellitus were identified by prescriptions for insulin, pulmonary emphysema by prescriptions for ipratropium bromide, and psychotic syndromes by prescriptions for haloperidol [1].
• Meconium ileus equivalent in association with nebulised ipratropium bromide in cystic fibrosis [2].
• Paralytic ileus associated with ipratropium [3].
• Effectiveness and safety of intranasal ipratropium bromide in common colds. A randomized, double-blind, placebo-controlled trial [4].
• Acute bronchodilating effects of ipratropium bromide and theophylline in chronic obstructive pulmonary disease [5].

Psychiatry related information on N-Isopropylatropine

• After an extensive screening program, 5,887 participants have been randomized to one of three groups: usual care, intervention with smoking cessation and the use of a placebo inhaler, and intervention with smoking cessation and the use of ipratropium bromide [6].
• RESULTS: Improvement in FEV1 and area under the FEV1 response-time curve from time 0 to 4 h (FEV1AUC0-4) was significantly greater for the combination of albuterol plus ipratropium than either agent alone on all test days [7].

High impact information on N-Isopropylatropine

• Children in the treatment group received 500 microg (2.5 ml) of ipratropium bromide with the second and third doses of albuterol; children in the control group received 2.5 ml of normal saline at these times [8].
• For patients with severe asthma (defined as a peak expiratory flow rate of <50 percent of the predicted value or an asthma score of 12 to 15), the addition of ipratropium significantly reduced the need for hospitalization (51 of 136 children [37.5 percent], as compared with 71 of 135 [52.6 percent] in the control group; P=0.02) [8].
• Long-term ipratropium bromide nebuliser therapy and lung mucociliary clearance [9].
• Sputum viscosity and long-term ipratropium bromide nebuliser therapy [10].
• Once-daily administration of tiotropium is well tolerated and has shown significant advantages over ipratropium bromide, given 4 times daily, in the control of COPD [11].

Chemical compound and disease context of N-Isopropylatropine

• A comparison of the effect of ipratropium and albuterol in the treatment of chronic obstructive airway disease [12].
• A multicenter, 85-day, double-blind, randomized study was conducted to compare the effects of a single-dose and chronic inhalation of ipratropium bromide solution (500 micrograms) to the beta-adrenergic agonist metaproterenol (5% solution, 15 mg) in patients with chronic obstructive pulmonary disease (COPD) [13].
• Effects of salmeterol on arterial blood gases in patients with stable chronic obstructive pulmonary disease. Comparison with albuterol and ipratropium [14].
• Comparative efficacy of salbutamol, ipratropium, and cromoglycate in the prevention of bronchospasm induced by exercise and hyperosmolar challenges [15].
• The bronchial hyperreactivity to MCh was completely blocked by pretreatment inhalation of ipratropium bromide, suggesting the muscarinic receptor-mediated mechanism [16].

Biological context of N-Isopropylatropine

• For patients with moderate asthma (indicated by a peak expiratory flow rate of 50 to 70 percent of the predicted value or an asthma score of 8 to 11 on a 15-point scale), hospitalization rates were similar in the two groups (ipratropium: 8 of 79 children [10.1 percent]; control: 9 of 84 [10.7 percent]) [8].
• 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 [17].
• This pooled effect size was equivalent to a 10% (95% CI: 2% to 18%) increase in forced expiratory volume in 1 second (FEV1) or peak expiratory flow in the ipratropium group compared with the control group [18].
• 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 [17].
• Clinical pharmacology and toxicology of ipratropium bromide [19].

Anatomical context of N-Isopropylatropine

• Pulmonary effects of sulfur dioxide exposure and ipratropium bromide pretreatment in adults with nonallergic asthma [20].
• Ipratropium bromide, two sprays (20 micrograms per spray) in each nasal cavity four times daily, for 3 weeks, produced a major reduction in nasal discharge severity and duration (p less than 0.00005 for daytime reduction in both) [21].
• Unlike ipratropium bromide (100 nM), which dissociated so quickly that there was little difference in the [3H]NMS association, compared with vehicle-treated membranes, Ba 679 BR (1 nM) had a strong protective effect against [3H]NMS binding ( > 70%) that lasted for 90 min [22].
• Like ipratropium bromide, Ba 679 BR showed no selectivity in its interactions with rat cerebrocortical M1 receptors (labeled with [3H]telenzepine) or heart M2 and salivary gland M3 receptors [labeled with [N-methyl-3H]scopolamine ([3H)] [22].
• CONCLUSION: Low-dose ipratropium can decrease airway size by the initial, preferential blockade of neuronal M2 muscarinic receptors, whereas a larger dose of ipratropium blocks M3 muscarinic receptors on airway smooth muscle, resulting in bronchodilation [23].

Associations of N-Isopropylatropine with other chemical compounds

• In some patients with COPD, beta agonists, theophylline, or corticosteroids may have some additive, but not synergistic, bronchodilator effects when given with ipratropium [24].
• Atropine has also been clearly demonstrated to depress ciliary beat frequency and to slow airway mucociliary clearance, whereas the short-term and long-term administration of ipratropium bromide at higher than clinically recommended doses seems to lack these effects [25].
• A multi-center, double-blind, 90-day study compared an ipratropium bromide metered-dose inhaler (40 microgram four times a day) with a metaproterenol metered-dose inhaler (1,500 micrograms four times a day) in 164 patients with asthma; of the 144 patients who completed the study, 71 received ipratropium and 73 received metaproterenol [26].
• OBJECTIVE: To compare the safety and efficacy of the combination of ipratropium bromide and albuterol sulfate with a commonly prescribed albuterol metered-dose inhaler containing albuterol base alone [27].
• This study has compared the short-term bronchodilator effects of inhaled anticholinergic (ipratropium bromide) and sympathomimetic (fenoterol) agents alone and in combination in 18 asthmatic patients. the study was of double-blind, placebo-controlled, crossover design [28].

Gene context of N-Isopropylatropine

• These results show that ipratropium bromide, given by nebulization, is safe and effective in the outpatient treatment of COPD [29].
• These results support the effectiveness and safety of long-term treatment with inhaled ipratropium in COPD [30].
• Ipratropium may also be effective when beta 2 agonists are not effective [31].
• For COPD a combination of ipratropium bromide and albuterol sulfate is more effective than albuterol base [27].
• Long-term treatment of perennial allergic rhinitis with ipratropium bromide nasal spray 0.06% [32].

Analytical, diagnostic and therapeutic context of N-Isopropylatropine

• Effect of nebulized ipratropium on the hospitalization rates of children with asthma [8].
• RESULTS: Overall, the rate of hospitalization was lower in the ipratropium group (59 of 215 children [27.4 percent]) than in the control group (80 of 219 [36.5 percent], P=0.05) [8].
• Bronchodilator: ipratropium bromide prescribed three times daily (two puffs per time) from a metered-dose inhaler [33].
• Ipratropium bromide nebulizer therapy and airway submucosal gland secretion [34].
• The bronchodilator effects of a single dose of ipratropium bromide aerosol (36 micrograms) and short-acting theophylline tablets (dose titrated to produce serum levels of 10-20 micrograms/mL) were compared in a double-blind, placebo-controlled crossover study in 21 patients with stable, chronic obstructive pulmonary disease [5].

References