Efficacy of Ipratropium Bromide Aqueous Nasal Spray in the Prevention of Nasal Secretion Induced by Inhaled Methacholine

Abstract

Objective: The present study was conducted to assess if a new formulation of ipratropium bromide nasal spray could prevent the nasal hypersecretion induced by a whole nasal challenge with increasing doses of methacholine.

Patients and methods: Twenty adult outpatients with ongoing hypersecretive rhinitis were selected and, after a preliminary session without any pretreatment, randomised to receive a single dose of nasal aqueous ipratropium bromide 80μg and matched placebo administered via a metered pump 60 minutes before methacholine challenge on two consecutive days. In each session, methacholine was inhaled into the nostrils at four increasing concentrations of 1, 4, 16 and 64 mg/ml, at 20-minute intervals. The induced secretion was evaluated by weighing a cotton tampon placed in each nostril for 30 seconds following the methacholine stimulation; weights were adjusted for spontaneous secretion. In addition, an acoustic rhinometer was used to measure the change in resistance and volume of each nasal cavity.

Results: The nasal discharge (adjusted for pretreatment values) was significantly reduced after pretreatment with ipratropium bromide, both in the cumulative weight (p < 0.01) and at each methacholine concentration (p < 0.05 after 1 and 4 mg/ml, p < 0.01 after 16 and 64 mg/ml). No relevant changes in nasal patency were observed during the test without pretreatment, nor during the two treatment sessions; similarly, no significant differences were observed in the comparison between active drug and placebo for both resistance and volume.

Conclusions: The results of the present study demonstrate that an intranasal aqueous solution of ipratropium bromide reduces the nasal discharge induced by locally applied methacholine. No effects were seen in the parameters used to measure nasal congestion.