The protective effect of ipratropium bromide aerosol against bronchospasm induced by hyperventilation and the inhalation of allergen, methacholine and histamine

The ability of the anticholinergic agent, ipratropium bromide, Atrovent, (40 mcg from a metered dose inhaler) to prevent bronchoconstriction produced by four different provocation tests was compared with placebo in 12 asthmatic patients. The provocation tests used were hyperventilation and inhalations of histamine, methacholine and an allergen to which the subject was known to be sensitive. The order in which each patient received the tests was determined according to a Latin-square design and remained the same on both test days. Pretreatment with ipratropium bromide and placebo was allocated randomly and administered in double-blind fashion. Ipratropium bromide provided significant protection at the 5% level against all four types of challenge. The average number of breaths required to produce a fall of at least 20% in FEV1 (forced expiratory volume in one second) was doubled for both histamine and allergen and increased by a factor of six for methacholine. The fall in FEV1 induced by hyperventilation was approximately halved. No side effects were noted with ipratropium bromide.