[Parasympathicolytic drugs in treatment of obstructive lung diseases (author's transl)]

In order to investigate the effect of ipratropium bromide in antigen induced bronchial obstruction 8 series of investigations were performed in patients with extrinsic asthma using bronchial provocation tests. The broncholytic effect of ipratropium bromide (0.1 and 0.25 mg in 1 ml solution) was significantly lower when compared with fenoterol and salbutamol and not clearly distinct from untreated controls, when airway resistance, thoracic gas volume and specific airway resistance were measured. No correlation of the effect of ipratropium bromide with bronchial reactivity to histamine, basal values and antigen induced obstruction as well as corticosteroid dependency could be ascertained. Increase of dosage did not lead to improved effectiveness. In contrast protective application of ipratropium bromide before antigen inhalation led to prevention of obstructions did disodium cromoglycate. It is concluded that regular prophylactic application of ipratropium bromide is more effective than bronchospasmolytic application. All forms of obstructive pulmonary disease are thus an indication for parasympathicolytic drugs provided they are used regularly.