Ipratropium bromide in acute asthma.

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Abstract
Ipratropium bromide was given to patients admitted to hospital with acute asthma. A cumulative-dose-response technique in six patients showed that 500 micrograms given by nebuliser produced a maximal increase in peak expiratory flow rate. This dose of ipratropium bromide was included in a regimen in which it was given either two hours before or two hours after nebulised salbutamol to 22 patients. Ipratropium bromide given on admission was as effective as nebulised salbutamol. The two drugs in sequence produced greater bronchodilatation than either used alone, and the mean peak expiratory flow rate rose by 96% in four hours. Thus giving ipratropium bromide in addition to salbutamol in severe asthma enhances the bronchodilator effect. Further studies are needed to determine whether the same effect may be obtained by giving two maximal doses of salbutamol two hours apart.