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. 1989 Apr;44(4):292–297. doi: 10.1136/thx.44.4.292

Peripheral nerve function in patients with chronic bronchitis receiving almitrine or placebo.

M B Allen 1, K Prowse 1
PMCID: PMC461797  PMID: 2548299

Abstract

A double blind prospective study of the effect of almitrine bismesylate and placebo on peripheral-nerve function was carried out in 12 patients with chronic bronchitis and arterial hypoxaemia (mean (SD) FEV1% predicted 38 (16), arterial oxygen tension (PaO2) 7.56 (0.76) kPa). Of the seven patients who took placebo, none developed symptoms or signs of peripheral neuropathy. One patient who had abnormal lower limb sensory nerve conduction initially showed improvement of sensory conduction but deterioration in motor conduction during the 12 month study period. Two further patients developed some slowing of motor conduction velocities in their right lateral popliteal nerve. Five patients received almitrine and all showed an improvement in PaO2 (mean from 7.0 to 7.9 kPa). None had symptoms or signs of peripheral neuropathy on entry to the study; one patient had evidence of impaired nerve conduction on electrophysiological testing. Three patients developed symptoms and signs of peripheral neuropathy during the 12 months of the study and a fourth developed peripheral neuropathy at 18 months, having continued to receive almitrine. Studies of nerve physiology showed abnormalities in the lower limbs of all four patients. Recovery was poor, possibly because of the long half life of almitrine. The studies suggest that almitrine may precipitate peripheral neuropathy in patients with chronic obstructive pulmonary disease. Patients should be warned of this potential complication so that the drug can be stopped as soon as symptoms develop.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alani S. M., Twomey J. A., Peake M. D. Almitrine and peripheral neuropathy. Lancet. 1985 Nov 30;2(8466):1251–1251. doi: 10.1016/s0140-6736(85)90784-6. [DOI] [PubMed] [Google Scholar]
  2. Appenzeller O., Parks R. D., MacGee J. Peripheral neuropathy in chronic disease of the respiratory tract. Am J Med. 1968 Jun;44(6):873–880. doi: 10.1016/0002-9343(68)90087-9. [DOI] [PubMed] [Google Scholar]
  3. Argov Z., Mastaglia F. L. Drug-induced peripheral neuropathies. Br Med J. 1979 Mar 10;1(6164):663–666. doi: 10.1136/bmj.1.6164.663. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Behse F., Buchthal F. Normal sensory conduction in the nerves of the leg in man. J Neurol Neurosurg Psychiatry. 1971 Aug;34(4):404–414. doi: 10.1136/jnnp.34.4.404. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Campbell D. B., Gordon B., Taylor A., Taylor D., Williams J. The biodisposition of almitrine bismesylate in man: a review. Eur J Respir Dis Suppl. 1983;126:337–348. [PubMed] [Google Scholar]
  6. Cavanagh J. B. The problems of neurons with long axons. Lancet. 1984 Jun 9;1(8389):1284–1287. doi: 10.1016/s0140-6736(84)92457-7. [DOI] [PubMed] [Google Scholar]
  7. Chedru F., Nodzenski R., Dunand J. F., Amarenco G., Ghnassia R., Ciaudo-Lacroix C., Said G. Peripheral neuropathy during treatment with almitrine. Br Med J (Clin Res Ed) 1985 Mar 23;290(6472):896–896. doi: 10.1136/bmj.290.6472.896. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. De Backer W., Vermeire P., Bogaert E., Janssens E., Van Maele R. Almitrine has no effect on gas exchange after bilateral carotid body resection in severe chronic airflow obstruction. Bull Eur Physiopathol Respir. 1985 Sep-Oct;21(5):427–432. [PubMed] [Google Scholar]
  9. Emirgil C., Sobol B. J., Heymann B., Shibutani K. Pulmonary function in alcoholics. Am J Med. 1974 Jul;57(1):69–77. doi: 10.1016/0002-9343(74)90770-0. [DOI] [PubMed] [Google Scholar]
  10. Faden A., Mendoza E., Flynn F. Subclinical neuropathy associated with chronic obstructive pulmonary disease: possible pathophysiologic role of smoking. Arch Neurol. 1981 Oct;38(10):639–642. doi: 10.1001/archneur.1981.00510100067011. [DOI] [PubMed] [Google Scholar]
  11. Gherardi R., Louarn F., Benvenuti C., Perrier M., Lejonc J. L., Schaeffer A., Degos J. D. Peripheral neuropathy in patients treated with almitrine dimesylate. Lancet. 1985 Jun 1;1(8440):1247–1250. doi: 10.1016/s0140-6736(85)92315-3. [DOI] [PubMed] [Google Scholar]
  12. Kinsman R. A., Yaroush R. A., Fernandez E., Dirks J. F., Schocket M., Fukuhara J. Symptoms and experiences in chronic bronchitis and emphysema. Chest. 1983 May;83(5):755–761. doi: 10.1378/chest.83.5.755. [DOI] [PubMed] [Google Scholar]
  13. Lane R. J., Routledge P. A. Drug-induced neurological disorders. Drugs. 1983 Aug;26(2):124–147. doi: 10.2165/00003495-198326020-00002. [DOI] [PubMed] [Google Scholar]
  14. Lees A. J., Robertson M., Trimble M. R., Murray N. M. A clinical study of Gilles de la Tourette syndrome in the United Kingdom. J Neurol Neurosurg Psychiatry. 1984 Jan;47(1):1–8. doi: 10.1136/jnnp.47.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Louarn F., Gherardi R. Almitrine and peripheral neuropathy. Lancet. 1985 Nov 9;2(8463):1068–1068. doi: 10.1016/s0140-6736(85)90936-5. [DOI] [PubMed] [Google Scholar]
  16. Mélot C., Naeije R., Rothschild T., Mertens P., Mols P., Hallemans R. Improvement in ventilation-perfusion matching by almitrine in COPD. Chest. 1983 Mar;83(3):528–533. doi: 10.1378/chest.83.3.528. [DOI] [PubMed] [Google Scholar]
  17. Narayan M., Ferranti R. Nerve conduction impairment in patients with respiratory insufficiency and severe chronic hypoxemia. Arch Phys Med Rehabil. 1978 Apr;59(4):188–192. [PubMed] [Google Scholar]
  18. Osteosarcoma. Lancet. 1985 Jul 20;2(8447):131–133. [PubMed] [Google Scholar]
  20. Spencer P. S., Sabri M. I., Schaumburg H. H., Moore C. L. Does a defect of energy metabolism in the nerve fiber underlie axonal degeneration in polyneuropathies? Ann Neurol. 1979 Jun;5(6):501–507. doi: 10.1002/ana.410050602. [DOI] [PubMed] [Google Scholar]
  21. Stradling J. R., Nicholl C. G., Cover D., Davies E. E., Hughes J. M., Pride N. B. Pattern of breathing and gas exchange following oral almitrine bismesylate in patients with chronic obstructive pulmonary disease. Eur J Respir Dis Suppl. 1983;126:255–264. [PubMed] [Google Scholar]
  22. Suggett A. J., Jarratt J. A., Proctor A., Howard P. Almitrine and peripheral neuropathy. Lancet. 1985 Oct 12;2(8459):830–831. doi: 10.1016/s0140-6736(85)90814-1. [DOI] [PubMed] [Google Scholar]

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