Title: Effect of Ipratropium Bromide and Tiotropium Bromide in Patients Suffers From Chronic Obstructive Pulmonary Disease (COPD), Attending in Tertiary Care Hospital, at S.K.M.C.H., Muzaffarpur

Authors: Dr Gaurav Tiwari, Dr G.P.Singh, Dr Deepak Kumar, Dr Satyendra Pathak

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i9.192

Abstract

Objective: The aim of present study was to compare the effect of 9 months treatment with inhaled Ipratropium bromide and inhaled Tiotropium bromide on airflow obstruction and symptoms, by assessing clinical improvement as well as alteration on pulmonary function tests in cases of mild to moderate chronic obstructive pulmonary disease (COPD).

Material and Methods: A total of 64 patients of 25-65 year of age group of either sex suffered from mild to moderate chronic obstructive pulmonary Disease (COPD) diagnosed by clinical examination, Pulmonary function tests (FEV1, FEV1/FVC, PEFR, FVC by spirometry) and Routine investigation (CBC, Blood sugar, LFT, KFT, Arterial Blood gas analysis, X-ray chest and ECG) were included in the study. All the patient were randomized into two treatment group, with equal proportion of patients (Group A-32 patients and Group- B 32 patients) on the basis of age, sex, severity of disease and smoking habits. Group A patients received inhalation of  Ipratropium bromide  40 micrograms by 6 hourly daily for 9 months and the group B patients received inhalation of  Tiotropium  bromide 18 micrograms  by once daily for 9 months. All the patients were followed up at 1 month, 3 months, 6 month and 9 months interval to monitor and improvements in clinical status, Pulmonary function tests, frequency of acute exacerbation and need of additional drugs. Any adverse effect of drugs and any changes in laboratory parameter were noted.

Results: Inhaled Tiotropium bromide was more effective in compare to Ipratropium bromide in patients with mild to moderate cases of COPD And Both drugs were equally effective in clinical improvements over the period of a months.

Conclusion:  It is suggested that Tiotropium bromide (18 micrograms OD) inhalation could be more suitable and acceptable by the patients of COPD due to its longer duration of action and it is more effectiveness as compared to Ipratropium bromide (40 micrograms QID inhalation).

Keywords:  COPD, Ipratropium  bromide ,Tiotropium bromide, Pulmonary function tests, Asthma.

References

  1. Lee, T. A., Wilkes, C., Joe, M., Strophe, K. T., Krishnan, J. A , Shamrock, G. T., Pickard, A. S. (2009). Outcomes Assoc-iated With Tiotropium Use in Patients With Chronic Obstructive Pulmonary Disease. Arch Intern Med 169: 1403-1410.
  2. Mac lay, J D, Rabinovich, R. A, Mack, W. (2009). Update in Chronic Obstructive Pulmonary Disease 2008. Am. J. Respir, Crit. Care Med.
  3. Osiris Therapeutics Reports Interim Data For COPD Stem Cell Study 2009. 4. Journal of pharmaceutical. sciences 2009 May.
  4. N Engl. J Med 2009;360:1329-35.
  5. Indian 30 an J Med Res. 2006 Dec; 124(6);619P -10
  6. Jindal S.K. A field study on follow LIP at years of prevalence of COPD and FEFR. Ind. J. Res. Med. 1993.
  7. American Thoracic Society, Standard for : diagnosis and care of patient with chronic obstructive airway disease. Am Res P. cri Care Med. (1995). The B
  8. British standard of care committee of British Thoracic Society (BTS) guidelines for Chest Thorax, 1997.

Corresponding Author

Dr Deepak Kumar

Associate Professor, Department of Pharmacology, Sri Krishna Medical College, Muzaffarpur, India