Bronchodialators

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jackmallory@webtv.net - 18 Jul 2004 19:54 GMT

Potential for Tolerance, Morbidity, and Mortality
Address:http://www.sma.org/smj/97feb2.htm Changed:5:44 PM on Tuesday,
December 31, 2002

I read Dr Giangrasso's monograph on bronchodialators Richard Friedel
was good enough to post the other day in a different thread.

Had been having, in the past few weeks, trouble with tachycardia at
pulmonary rehab. (Fast heartbeat) Solved that one (maybe) by cutting
way back on the dose of albuterol I was taking by nebulizer along with
the Atrovent (ipratropium). I'm considering using the former only by
MDI (and only p/rn). The spray doses are much weaker.

No one hopes more than I do that the good effects Ventolin exercises on
me will continue. I have exercise (and stress) induced asthma and
emphysema.

Today was a good time to review the article above.---Jack

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CBI - 19 Jul 2004 18:45 GMT

> Potential for Tolerance, Morbidity, and Mortality
> Address:http://www.sma.org/smj/97feb2.htm Changed:5:44 PM on Tuesday,
[quoted text clipped - 14 lines]
>
> Today was a good time to review the article above.---Jack

What you say makes sense. Atrovent is especially useful for emphysema
patients as it affects the part of the respiratory tree that is more
at issue. it also does not cuase as much tachycardia as albuterol.

The literature on nebs vs. MDI's is interesting. Nebs deliver about 10
times the amount of drug. A lot of research suggests, however, that
they are no better than MDI's, even in an acute attack. I think the
reason for this is that in most cases, even during an attack, the
amoint provided by the MDI is sufficient and the extra fromt he neb is
wasted (on the lung tissue - apparently not ont he heart).

Having said all that I do believe that for several reasons some people
do better with the nebs.

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CBI, MD

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