Respiratory and circulatory effects and other side effects of buffer solution, prostaglandin (PG)E
1 and metaproterenol aerosol were compared in the same patients with bronchial asthma.
The effects of infused PGE
1 were also compared with those of inhaled PGE
1 aerosols. Aerosols were inhaled through IPPB (Bennett PR-2) for about ten minutes with dosages of 50μg for PGE
1 and 10mg for metaproterenol. 50μg PGE
1 in a saline solution was infused intravenously for about five minutes.
Airway resistance (R
A), functional residual capacity (FRC) and specific airway conductance (SG
A) were measured by whole body-plethysmograph before and after administration. Systemic blood pressure and heart rate were also examined by sphygmomanometer and electrocardiogram respectively. The conclusions derived are as follows
In eleven subjects, control aerosol (sucrose-menthol-saline without PGE
1) did not show any bronchodilating effects, irritation of throat, or circulatory changes, whereas in the same subjects, sucrose-menthol-saline aerosol with PGE
1 showed bronchodilating effects for ten to thirty minutes. Inhalation of PGE
1 aerosol also showed a slight hypotensive effect, and a productive cough was also seen in most of the subjects.
Therefore, the bronchodilating, hypotensive and other side effects are thought to be due to PGE
1 itself, not due to control aerosol. The bronchodilating effects of PGE
1 aerosol were significantly evident in patients with marked bronchoconstriction.
In some subjects, bronchoconstriction also occurred due to PGE
1 aerosol. However, no correlation was found between such bronchoconstriction by PGE
1 and the cough seen during inhalation.
Intravcnous infusion of 50μg PGE
1 rcvcaled a slight bronchodilating effect of short duration in only six out of twenty subjects. A marked fall of blood pressure, especially in hypertensive patients, and atrial tachycardia of short duration also occurred.
Intravenous infusion of PGE
1 also produced cough in two out of twenty subjects, palpitation in four, and headache in one, respectively.
Inhalation of 10mg metaproterenol revealed marked bronchodilating effect, without circulatory or other side effects.
The bronchodilating potency of 10mg metaproterenol aerosol was thought to be slightly stronger than that of 50μg PGE
1 aerosol in the same 13 subjects. But no significant difference was seen between the percent changes of SG
A after PGE
1 and metaproterenol aerosol. Therefore, the bronchodilating potency of PGE
1 aerosol is about two hundred times stronger than that of metaproterenol aerosol.
Considering about the side effects and ronchodilating potency, metaproterenol aerosol is better suited for clinical application than PGE
1 aerosol.
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