Abstract

Bronchodilation with anticholinergics and b2-agonists is the keystone of pharmacological therapy for COPD. The aim of this study was to assess the bronchodilator response of the COPD patients and the duration of bronchodilator effect of inhaled ipratropium bromide (IB) compared to salbutamol. Pulmonary function tests (PFT) were performed in 35 patients and the spirometric tests were repeated after 15 and 60 minutes and then hourly for 6 hours after medication (first day with salbutamol, the next day with IB). Baseline FVC 2.94±0.94 L and FEV1 1.55±0.70 L in IB group whereas 2.87±0.91 L and 1.55±0.70 L in salbutamol group. At 6th hour after inhalation FVC 3.22±0.88 L and FEV1 1.73±0.70 L in IB group and 3.16±0.90 L for FVC and 1.66±0.72 L for FEV1 in salbutamol group. Significance of FVC and FEV1 increase continued during 6 hours for both bronchodilators (p<0.0001). Baseline FEF25-75 was found to be 0.73±0.48 L/s (21.08±10.77% pred) in salbutamol group and 0.70±0.48 L/s (20.56±11.01% pred) in ipratropium group. At fifth hour of salbutamol inhalation and ipratropium inhalation, FEF25-75 was 0.80±0.58 L/s (p>0.05) and 0.83±0.61 L/s (p=0.005) consequently. We conclude that airflow limitation in COPD can be significantly relieved by the use of inhaled bronchodilators and compared to ipratropium bromide, bronchodilation induced by salbutamol was found to be less marked and shorter duration.