Effects of Combined Treatment With Glycopyrrolate and Albuterol in Acute Exacerbation of Chronic Obstructive Pulmonary Disease, ,

Study objective: To investigate whether the addition of a single aerosolized dose of glycopyrrolate leads to a greater improvement in pulmonary function than treatment with albuterol alone for patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Design: Prospective, randomized, blinded, controlled study. Fifty-seven patients with acute exacerbation of COPD were entered into the study. All patients received three aerosol treatments. Patients were randomized to recive 2 mg aerosolized glycopyrrolate (combination therapy group) or aerosolized placebo in addition to their first 2.5-mg of aerosolized albuterol alone for the next two treatments. Setting: Urban teaching hospital emergency department. Results: We found no difference in pretreatment 1-second fractional expired volume (FEV1) between the control and glycopyrrolate groups. There was no significant difference in the absolute value of the FEV1 at 1 hour or at 3 hours between the two groups; however, patients who received combination therapy had a greater percent increase from the pretreatment value of FEV1(56%) as measured in milliliters than did control patients (19%; P =.008). Conclusion: The combination of glycopyrrolate and albuterol produces a greater improvement in FEV1 than does albuterol alone in the treatment of patients with acute exacerbation of COPD. [Cydulka RK, Emerman CL: Effects of combined treatment with glycopyrrolate and albuterol in acute exacerbation of chronic obstructive pulmonary disease.Ann Emerg Med April 1995;25:470-473.]