[Comparative evaluation of effects of various bronchodilators in sarcoidosis]

The investigation was undertaken to compare three bronchodilators on patients with respiratory sarcoidosis. Ninety patients (66 females and 24 males) with intrathoracic sarcoidosis were examined. X-ray stages I, II, III, and IV were seen in 48.9, 46.7, 3.3, and 1.1%, respectively. A flow-volume curve was recorded on a Masterscreen Pnevmo apparatus (Erich Jaeger) before and after inhalations of salbutamol (200 micrograms, a flask), ipratropium bromide (40 micrograms, a flask), and 1 ml of berodual solution through a Boreal nebulizer. The mean baseline values of forced expiration were normal, except for MOS75 (51.0 +/- 1.3% of the normal values). After salbutamol, the increment of MOS75 was higher than that after ipratropium (20.7 +/- 3.1% and 12.3 +/- 2.3%, respectively, p < 0.05); however, after berodual nebulization, the increase in MOS50 was greater than that after inhalation of ipratropium (17.2 +/- 1.9% versus 10.7 +/- 1.6%, p < 0.05) or salbutamol (10.1 +/- 6%, p < 0.01). The changes in these parameters in smokers and nonsmokers were similar. The one-month or more inhalation of budesonide (benacort) potentiated the bronchodilating action of salbutamol on all the parameters of forced expiration, but failed to affect the effect of ipratropium and berodual. Prednisolone did not affect the effects of bronchodilators. A combination of beta 2 agonist and inhaled steroid may be effective in intrathoracic sarcoidosis with the bronchial obstruction syndrome. The mechanism of varying action of the drugs having different mechanisms of action requires further investigations.