Skip to main content
NCBI home page
Thorax logoLink to Thorax
. 1978 Dec;33(6):694–699. doi: 10.1136/thx.33.6.694

Sodium cromoglycate and ipratropium bromide in exercise-induced asthma.

N C Thomson, K R Patel, J W Kerr
PMCID: PMC470965  PMID: 154747

Abstract

In thirteen patients with extrinsic asthma the effects of placebo, sodium cromoglycate, ipratropium bromide, and ipratropium bromide plus sodium cromoglycate were studied in a random double-blind fashion to assess their inhibitory action in exercise-induced asthma (EIA). Exercise testing consisted of steady state running on an inclined treadmill for up to eight minutes. In eight of the 13 patients studied the baseline ratio of expiratory flow at 50% vital capacity (VC) breathing helium-oxygen (V50He) to V50air was over 1.20 and they were called responders; the remaining five patients were called non-responders. There was a significantly lower baseline maximum mid-expiratory flow rate (MMEF) in non-responders (P less than 0.02) as compared to responders but no difference in forced expiratory volume in one second (FEV1) or forced vital capacity (FVC). Sodium cromoglycate (P less than 0.02), ipratropium bromide (P less than 0.01), and ipratropium bromide plus spdium cromoglycate (P less than 0.01) all significantly inhibited the percentage fall in FEV1 after exercise in the responders. Ipratropium bromide had no preventive action on non-responders, unlike sodium cromoglycate (P less than 0.05) and ipratropium bromide plus sodium cromoglycate (P less than 0.02). It is postulated that mediator release is an important factor in development of EIA in most extrinsic asthmatics, whereas cholinergic mechanisms are relevant only in those patients in whom the main site of airflow obstruction is in the large central airways.

Full text

PDF
694

Selected References

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

  1. Antic R., Macklem P. T. The influence of clinical factors on site of airway obstruction in asthma. Am Rev Respir Dis. 1976 Nov;114(5):851–859. doi: 10.1164/arrd.1976.114.5.851. [DOI] [PubMed] [Google Scholar]
  2. Cavanaugh M. J., Cooper D. M. Inhaled atropine sulfate: dose response characteristics. Am Rev Respir Dis. 1976 Sep;114(3):517–524. doi: 10.1164/arrd.1976.114.3.517. [DOI] [PubMed] [Google Scholar]
  3. Chan-Yeung M., Abboud R., Tsao M. S., Maclean L. Effect of helium on maximal expiratory flow in patients with asthma before and during induced bronchoconstriction. Am Rev Respir Dis. 1976 Apr;113(4):433–443. doi: 10.1164/arrd.1976.113.4.433. [DOI] [PubMed] [Google Scholar]
  4. Chan-Yeung M. The effect of Sch 1000 and disodium cromoglycate on exercise-induced asthma. Chest. 1977 Mar;71(3):320–323. doi: 10.1378/chest.71.3.320. [DOI] [PubMed] [Google Scholar]
  5. Cherniack R. M., Raber M. B. Normal standards for ventilatory function using an automated wedge spirometer. Am Rev Respir Dis. 1972 Jul;106(1):38–46. doi: 10.1164/arrd.1972.106.1.38. [DOI] [PubMed] [Google Scholar]
  6. Cooper J. B. Twin pigeon embryos. Poult Sci. 1976 Sep;55(5):1976–1977. doi: 10.3382/ps.0551976. [DOI] [PubMed] [Google Scholar]
  7. Cox J. S., Orr T. S., Pollard M. C., Gwilliam J. Mode of action of disodium cromoglycate, studies on immediate type hypersensitivity reactions using 'double sensitization' with two antigenically distinct rat reagins. Clin Exp Immunol. 1970 Nov;7(5):745–757. [PMC free article] [PubMed] [Google Scholar]
  8. Davies S. E. Effect of disodium cromoglycate on exercise-induced asthma. Br Med J. 1968 Sep 7;3(5618):593–594. doi: 10.1136/bmj.3.5618.593. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Despas P. J., Leroux M., Macklem P. T. Site of airway obstruction in asthma as determined by measuring maximal expiratory flow breathing air and a helium-oxygen mixture. J Clin Invest. 1972 Dec;51(12):3235–3243. doi: 10.1172/JCI107150. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Godfrey S., König P. Inhibition of exercise-induced asthma by different pharmacological pathways. Thorax. 1976 Apr;31(2):137–143. doi: 10.1136/thx.31.2.137. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Gold W. M. The role of the parasymphathetic nervous system in airways disease. Postgrad Med J. 1975;51(7 Suppl):53–62. [PubMed] [Google Scholar]
  12. Ingram R. H., Jr, Wellman J. J., McFadden E. R., Jr, Mead J. Relative contributions of large and small airways to flow limitation in normal subjects before and after atropine and isoproterenol. J Clin Invest. 1977 Apr;59(4):696–703. doi: 10.1172/JCI108688. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Kaliner M., Orange R. P., Austen K. F. Immunological release of histamine and slow reacting substance of anaphylaxis from human lung. J Exp Med. 1972 Sep 1;136(3):556–567. doi: 10.1084/jem.136.3.556. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. McFadden E. R., Jr, Ingram R. H., Jr, Haynes R. L., Wellman J. J. Predominant site of flow limitation and mechanisms of postexertional asthma. J Appl Physiol Respir Environ Exerc Physiol. 1977 May;42(5):746–752. doi: 10.1152/jappl.1977.42.5.746. [DOI] [PubMed] [Google Scholar]
  15. McFadden E. R., Jr, Linden D. A. A reduction in maximum mid-expiratory flow rate. A spirographic manifestation of small airway disease. Am J Med. 1972 Jun;52(6):725–737. doi: 10.1016/0002-9343(72)90078-2. [DOI] [PubMed] [Google Scholar]
  16. Simonsson B. G. Reflex control of airways calibre. Bull Physiopathol Respir (Nancy) 1972 May-Jun;8(3):439–446. [PubMed] [Google Scholar]
  17. Tinkelman D. G., Cavanaugh M. J., Cooper D. M. Inhibition of exercise-induced bronchospasm by atropine. Am Rev Respir Dis. 1976 Jul;114(1):87–94. doi: 10.1164/arrd.1976.114.1.87. [DOI] [PubMed] [Google Scholar]
  18. Vincent N. J., Knudson R., Leith D. E., Macklem P. T., Mead J. Factors influencing pulmonary resistance. J Appl Physiol. 1970 Aug;29(2):236–243. doi: 10.1152/jappl.1970.29.2.236. [DOI] [PubMed] [Google Scholar]
  19. Widdicombe J. G., Sterling G. M. The autonomic nervous system and breathing. Arch Intern Med. 1970 Aug;126(2):311–329. [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES