1.The Efficacy of Cimetropium Bromide as a Premedication before Esophagogastroduodenoscopy.
Jue Yong LEE ; Sung Jung KIM ; Chang Soon CHOI ; Young Mook KIM ; Hyun Joo JEONG ; Jung Eun LEE ; Gwang Ho BAIK ; Jin Bong KIM ; Dong Joon KIM
Korean Journal of Gastrointestinal Endoscopy 2008;37(6):403-408
BACKGROUND/AIMS: Cimetropium bromide has been used widely as a premedication for endoscopy; however, there are no subjective data pertaining to the effects of cimetropum bromide as a premedication. Thus, the current study was undertaken to compare the effects of cimetropum bromide with placebo as a premedication for esophagogastroduodenoscopy (EGD). METHODS: Two hundred ninety-nine consecutive outpatients who had undergone EGD were enrolled in this study. Thirty minutes before EGD, the patients were randomly given an intramuscular injection of cimetropium bromide (5 mg) or saline using a placebo-controlled, double-blind, randomized technique. Immediately after EGD, all the patients and endoscopists were requested to fill out the questionnaire form. RESULTS: One-hundred patients were injected with cimetropium bromide and 150 patients were injected with placebo. There was no statistically significant difference in the degree of residual gastric secretions, the peristaltic activity detected by endoscopists, and the comfort experienced by the patients in each study group. CONCLUSIONS: The intramuscular injection of cimetropium bromide (5 mg) as a premedication for EGD was not significantly superior to placebo, at least with respect to subjective parameters, in spite of its broad use.
Endoscopy, Digestive System
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Humans
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Injections, Intramuscular
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Outpatients
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Parasympatholytics
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Premedication
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Scopolamine Derivatives
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Surveys and Questionnaires
2.Issues on Safety of Long-Acting Muscarinic Antagonist.
Yang Deok LEE ; Yongseon CHO ; Min Soo HAN
Tuberculosis and Respiratory Diseases 2011;70(5):384-389
The prevention of and the controlling of symptoms, reductions in the frequency of exacerbations, and disease severity are central to the pharmacologic therapy of chronic obstructive pulmonary disease (COPD). COPD patients are inclined to be older, have more comorbidities, and use polypharmacy as a result. Long-acting inhaled muscarinic antagonists (LAMAs) is a preferred treatment modality. However, the cardiovascular (CV) safety of anti-cholinergics, including LAMA, has been an issue. In contrast, the results of the UPLIFT trial and a pooled analysis of data from 30 trials of tiotropium illustrates the association of tiotropium with reductions in the risk of all cause mortality, CV mortality and CV events. And, the UPLIFT trial provides clues regarding the additive advantages of tiotropium in COPD patients who already are using long-acting inhaled beta2 agonists and inhaled corticosteroids. Following the contribution of tiotropium as a first LAMA, new LAMAs such as aclidinium and glycopyrrolate (NVA-237) seem to be emerging.
Adrenal Cortex Hormones
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Cholinergic Antagonists
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Comorbidity
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Glycopyrrolate
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Humans
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Muscarinic Antagonists
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Polypharmacy
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Pulmonary Disease, Chronic Obstructive
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Scopolamine Derivatives
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Tiotropium Bromide
3.Therapeutic effect of compound anisodine for primary open angle glaucoma.
Journal of Zhejiang University. Medical sciences 2011;40(6):659-662
OBJECTIVETo evaluate the therapeutic effect of compound anisodine (CA) for patients with primary open angle glaucoma (POAG).
METHODSAccording to the modified Hodapp-Parrish-Anderson Visual Fields Grading System, 46 patients with moderate stage POAG were randomized to receive compound anisodine injection (CA group) or venoruton tablets (control group). Visual acuity (VA), IOP, fundus, visual fields (VF) and the blood flow of optic nerve were observed.
RESULTSThe mean of defect (MD) was decreased in CA group after treatment. The PSV and EDV of ophthalmic artery were remarkably improved in both groups, as well as the PSV, EDV and RI of retinal central artery. Compound anisodine was superior in improving hemodynamics of ophthalmic artery and retinal central artery to venoruton.
CONCLUSIONCompound anisodine can protect optic nerve of POAG through improving the visual function and blood supply of optic nerve.
Adult ; Female ; Glaucoma, Open-Angle ; drug therapy ; Humans ; Male ; Middle Aged ; Scopolamine Derivatives ; therapeutic use ; Treatment Outcome
4.Efficacy of tiotropium as add-on therapy for adults with uncontrolled asthma.
Villalobos Ralph Elvi M. ; Uy Charles Vincent O. ; Yu Marc Gregory Y. ; Jorge Manuel C.
Acta Medica Philippina 2016;50(2):56-61
OBJECTIVE: The study aimed to evaluate efficacy of tiotropium as add-on therapy on top of standard regimens for uncontrolled asthma, specifically in terms of FEV1, morning and evening PEF, reduction in exacerbations, rescue medication use, and quality of life improvement.
METHODS: A search was done for eligible trials after which validity screen and data extraction was performed. Results were presented as mean differences, standard errors, and 95% confidence intervals, and graphically as forest plots. Estimates were pooled using the random effects model with I2 and Chi2 tests used to assess heterogeneity. Adverse events were reported as dichotomous variables.
RESULTS: Four studies were included totaling 1617 participants. The tiotropium group had statistically significant improvement in FEV1 (95% Cl, 0.14 [0.09, 0.19], p<0.00001), morning (95% Cl, 20.03 [11.71, 28.35], p<0.00001) with trend towards benefit in reduction of rescue medications (95% Cl, 0.12 [-0.17,0.4],p=0.42) and quality of life improvements (95% Cl, 0.1 [-0.05,0.25], p=0.20). Homogeneity (I2= 0%, Chi2= 0.47-3.22) was found across studies.
CONCLUSION: Tiotropium is associated with significant improvement in pulmonary function among patients with uncontrolled asthma, with possible benefit in reduction of rescue medications and quality of life improvement.
Human ; Male ; Female ; Adult ; Asthma ; Bronchodilator Agents ; Confidence Intervals ; Quality Of Life ; Respiratory Physiological Phenomena ; Scopolamine Derivatives ; Tiotropium Bromide ; Meta-analysis
7.Analysis of anisodine and its metabolites in rat plasma by liquid chromatography-tandem mass spectrometry.
Huai-Xia CHEN ; Peng DU ; Feng-Mei HAN ; Yong CHEN
Acta Pharmaceutica Sinica 2006;41(6):518-521
AIMTo identify anisodine and its metabolites in rat plasma after ingestion of anisodine by combining liquid chromatography and tandem mass spectrometry (LC-MS(n)).
METHODSPlasma samples from rats after a single orally administration of 20 mg anisodine were added with methanol to precipitate protein. Then, it was analyzed by LC-MS(n). Identification and structural elucidation of the metabolites were performed by comparing their changes in molecular masses, retention-times and full scan MS(n) spectra with those of the parent drug and blank plasma.
RESULTSThe results revealed that the parent drug and its four metabolites (norscopine, scopine, hydroxyanisodine, N-oxide anisodine) existed in rat plasma.
CONCLUSIONThis method is sensitive, rapid, simple, and it is suitable for the rapid identification of drug and its metabolits.
Administration, Oral ; Animals ; Chromatography, Liquid ; methods ; Plants, Medicinal ; chemistry ; Rats ; Rats, Wistar ; Scopolamine Derivatives ; isolation & purification ; metabolism ; Sensitivity and Specificity ; Solanaceae ; chemistry ; Tandem Mass Spectrometry ; methods
8.Comparison for the Effects of Triple Therapy with Salmeterol/Fluticasone Propionate and Tiotropium Bromide versus Individual Components in Patients of Severe COPD Combined with Bronchial Hyperresponsiveness.
Ji Youn SOHN ; So Ri KIM ; Seoung Ju PARK ; Heung Bum LEE ; Yong Chul LEE ; Yang Keun RHEE
Tuberculosis and Respiratory Diseases 2009;67(6):536-544
BACKGROUND: A combination of salmeterol and fluticasone propionate (SFC) and tiotropium bromide (TIO) is commonly prescribed for COPD patients but there is little data on their effectiveness, particularly in COPD patients with bronchial hyperresponsiveness. This study compared the spirometric improvement based on the change in FEV1, FEV1/FVC, and IC as well as the clinical outcomes of the therapeutic strategies with SFC and TIO versus the individual components in patients with severe COPD and bronchial hyperresponsiveness. METHODS: This study examined the spirometric data and clinical outcomes of 214 patients with COPD and hyperresponsiveness, who were divided into three groups according to the therapeutic regimen (TIO only, SFC only, and a triple therapy regimen). RESULTS: All regimen groups showed early improvement in the FEV1 and IC (at 3- and 6 months after treatment). However, long-term beneficial effects were observed only in the SFC group (at 24 months after treatment). However, these beneficial effects decreased after a 36-month follow up. In all spirometric results, the 12-, 24-, and 36-months data showed a similar degree of improvement in the three groups. The triple therapy group showed higher St. George's Respiratory Questionnaire scores and lower acute exacerbations and hospitalization. CONCLUSION: SFC can be a more important component in the pharmacological treatment of severe COPD patients with hyperresponsiveness than TIO, particularly in the spirometric and clinical outcomes.
Albuterol
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Androstadienes
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Diethylpropion
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Drug Therapy, Combination
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Follow-Up Studies
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Hospitalization
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Humans
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Pulmonary Disease, Chronic Obstructive
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Surveys and Questionnaires
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Scopolamine Derivatives
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Treatment Outcome
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Fluticasone
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Tiotropium Bromide
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Salmeterol Xinafoate
9.Therapeutic effect of tiotropium bromide powder inhalation in patients with stable bronchiectasis.
Xiao-ling LI ; Shao-xi CAI ; Hai-jin ZHAO ; Li-min DONG ; Xiang-bo SHEN ; Lai-yu LIU ; Guo-dong HU
Journal of Southern Medical University 2010;30(5):1072-1074
OBJECTIVETo observe the therapeutic effect of tiotropium bromide powder inhalation on stable bronchiectasis.
METHODSTwenty-two patients with stable bronchiectasis received inhalation of totropium bromide powder at the daily dose of 18 microg, and on days 1 and 28, the patients were examined for forced expiratory volume in one second (FEVl), predicted value [FEVl(%)], forced expiratory volume (FEV), and FEVl/FVC. The symptom score and BODE index were also recorded.
RESULTSAfter 1 month of inhalation therapy, the FEV1% of the patients showed a moderate increase but the increment was not statistically significant (t=-1.875, P>0.05); the symptom score and BODE index decreased significantly after the therapy (t=7.091, P<0.001; t=2.982, P<0.05).
CONCLUSIONLong-term inhalation of tiotropium bromide powder can improve the clinical symptoms and BODE index and enhance the exercise tolerance and quality of life of the patients with bronchiectasis.
Administration, Inhalation ; Adult ; Aged ; Bronchiectasis ; drug therapy ; Female ; Forced Expiratory Volume ; Humans ; Male ; Middle Aged ; Powders ; Receptor, Muscarinic M3 ; antagonists & inhibitors ; Scopolamine Derivatives ; administration & dosage ; Tiotropium Bromide
10.The Combination of Tiotropium and Budesonide in the Treatment of Chronic Obstructive Pulmonary Disease.
Sang Won UM ; Chul Gyu YOO ; Young Whan KIM ; Sung Koo HAN ; Young Soo SHIM
Journal of Korean Medical Science 2007;22(5):839-845
Because additive effects of inhaled corticosteroids and long-acting anticholinergics are unclear, we undertook this study to compare the efficacy of tiotropium alone and tiotropium plus budesonide in patients with chronic obstructive pulmonary disease. The study subjects were randomized to receive either tiotropium 18 microgram once daily with or without budesonide 200 microgram twice daily for 6 weeks. The efficacy variables were changes in trough forced expiratory volume in one second (FEV1), St. George's Respiratory Questionnaire (SGRQ), 6-minute walk distance (6MWD), and use of rescue medication. One hundred patients were randomized and 81 completed the study. The mean age was 64.0 yr, and the mean FEV1 was 39.7% predicted. Compared with tiotropium alone (N=40), the tiotropium/budesonide combination (N=41) was related to an improvement in the SGRQ total score (tiotropium -2.8 units and tiotropium/budesonide -5.6 units, p=0.003). 6MWD was improved by 13.5 m in the tiotropium group and by 22.5 m in the tiotropium/budesonide group (p=0.031). Changes in trough FEV1 and the use of rescue medication were similar between two groups. In conclusion, compared with tiotropium alone, the tiotropium/ budesonide combination was related to an improved health-related quality of life. These data support that low-dose budesonide may enhance the efficacy of tiotropium.
Aged
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Bronchodilator Agents/*administration & dosage
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Budesonide/*administration & dosage
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Exercise
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Female
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Humans
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Male
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Middle Aged
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Models, Statistical
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Pulmonary Disease, Chronic Obstructive/*drug therapy
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Quality of Life
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Questionnaires
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Scopolamine Derivatives/*administration & dosage
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Spirometry/methods
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Treatment Outcome