Comparison between long-term treatment of chronic bronchitic airway obstruction with ipratropium bromide and...

Twenty-eight patients with chronic obstructive lung disease with a reversible component were treated with either 40 micrograms of ipratropium bromide (IB) or 1.5 mg of metaproterenol (MP) by a metered dose inhaler four times a day in a double-blind randomized fashion. The treatment was continued for 3 months and pulmonary function tests and clinical evaluation were made on days, 1, 30, 45, 60, and 90. IB produced significantly greater bronchodilatation between one and three hours compared with MP. Furthermore, patients receiving IB showed no decline in effectiveness over 3 months, in contrast to MP which showed some evidence of development of drug tolerance within the same period. No side effects were noted. It is concluded that the anti-cholinergic agent IB is a more effective bronchodilator at the doses used in the above group of patients, both acutely and over a long-term period.