Pulmonary Mechanics in Man after Administration of Atropine and Neostigmine

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Abstract
In order to assess the effects of atropine and neostigmine on airway mechanics, atropine, 0.008 mg/kg, a mixture of atropine, 0.00375 mg/kg, neostigmine 0.015 mg/kg, and d-tubocurarine, 1 mg and d-tubocurarine, 1 mg, alone were injected i.v. into 6 healthy volunteers. d-Tubocurarine was added to antagonize the nicotinic effects of neostigmine, in particular muscle twitching. Measurements were made of maximum expiratory flow, closing volume and total airway resistance, as well as conventional pulmonary function tests, 30 min before and 10 and 60 min after each injection. Atropine alone increased maximum mid-expiratory flow 13% 10 min and 18% 60 min after the injection and maximum expiratory flow at 50% of total lung capacity 12% 10 min and 20% 60 min after the injection. These changes were significant and indicate a decrease in the resistance of small airways. Despite the fact that all the volunteers experienced typical muscarinic effects, the only significant change by the mixture of atropine, neostigmine and d-tubocurarine was a 17% increase in total airway resistance. Neither atropine nor neostigmine changed the collapsibility of small airways, as indicated by the relatively stable closing volume. d-Tubocurarine, 1 mg, alone did not change the results of any of the tests of pulmonary function.

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