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Clinical Investigations: PULMONARY FUNCTION TEST |

The Effect of Ipratropium Nasal Spray on Bronchial Methacholine Challenge*

John K. Reid, MD; Beth E. Davis, BSc; Donald W. Cockcroft, MD
Author and Funding Information

*From the Division of Respiratory, Critical Care, and Sleep Medicine, University of Saskatchewan, Saskatoon, SK, Canada.

Correspondence to: Donald W. Cockcroft, MD, Division of Respiratory, Critical Care, and Sleep Medicine, University of Saskatchewan, 5th Floor, Ellis Hall, 103 Hospital Dr, Saskatoon, SK, Canada S7N 0W8; e-mail: cockcroft@sask.usask.ca



Chest. 2005;128(3):1245-1247. doi:10.1378/chest.128.3.1245
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Purpose: To determine the effect ipratropium bromide nasal spray has on methacholine challenge testing for airway hyperresponsiveness.

Materials and methods: Ten subjects with known airway hyperresponsiveness to methacholine who had been clinically stable in the preceding 2 months participated in a randomized, double-blind, placebo-controlled, crossover study. Methacholine challenge testing was conducted on successive days: day 1 after pretreatment with aqueous 0.03% nasal ipratropium, and day 2 with normal saline solution placebo.

Results: The provocative concentration of methacholine causing a 20% fall in FEV1 (PC20) was higher after nasal ipratropium than after saline solution placebo (2.1 mg/mL vs 1.6 mg/mL, p = 0.02). This difference is equal to approximately one-half concentration difference, probably within the limits of reproducibility of the test.

Conclusions: Pretreatment with nasal ipratropium results in a small increase in PC20. Although this difference achieves statistical significance, it is probably not clinically significant.

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