Common cold and high-dose ipratropium bromide: use of anticholinergic medication as an indicator of reflex-mediated hypersecretion
Ostberg, B.; Winther, B.; Borum, P.; Mygind, N.
Rhinology 35(2): 58-62
1997
ISSN/ISBN: 0300-0729 PMID: 9299652 Document Number: 473314
It was our aim to study the role played by parasympathetic reflexes for the amount and physical characteristics of nasal discharge during a common cold, and to define the maximum anti-rhinorrhoea effect obtainable with anticholinergic medication. Fifty adults with naturally acquired colds were treated with a very high dose of the topically active cholinoceptor-antagonist ipratropium bromide in a randomized, double-blind, placebo-controlled study of parallel groups. A dosage of 400mug was given 4 times daily for 3 days, using a specially manufactured high-dose pressurized aerosol. This treatment resulted in a 56% reduction in the number of nose blowings (p<0.01) and a 58% reduction in the weight of blown secretions (p<0.01). Assessment of the 'pourability' of the nasal discharge indicated that ipratropium bromide mainly reduces the watery secretions but not the mucopurulent secretions. The high dose of ipratropium bromide caused nose- and mouth dryness in a considerable number of the patients. In conclusion: (1) during the first days of a common cold about 60% of the nasal discharge is a reflex-mediated product from nasal glands; (2) this type of secretion is predominantly watery; and (3) ipratropium bromide can reduce watery rhinorrhoea in the common cold, but a lower dose is required in order to avoid side effects.