Effect of Cholinergic Receptor Antagonists on the Potentiation of the Effect of Adenosine Receptor Blockers in People with Bronchial Asthma

Lirim Mustafa¹, Hilmi Islami², Mirlinda Havolli¹, Fitim Alidema³, Pellumb Islami⁴, Arta Dauti⁴, Fellenza Abazi¹ and Demush Bajraktari^5*

¹Iliria College, Department of Health Management, Prishtina, Republic of Kosova ²Department of Pharmacology, Faculty of Medicine, University of Prishtina, Prishtina, Republic of Kosova ³Medical Sciences Faculty, UBT Higher Education Institution, Prishtina, Republic of Kosova ⁴University Clinical Centre of Kosovo- Prishtina, Republic of Kosova ⁵Faculty of Pharmacy, UBT Higher Education Institution, 10000 Prishtina, Kosovo Corresponding Author E-mail: demush.bajraktari@ubt-uni.net

Abstract: Background: The interaction between adenosine receptor blockers and anticholinergic substances in the treatment of bronchial asthma is an area of interest. The efficacy of such combinations in managing bronchial asthma and bronchial hypersensitivity needs to be explored further. Understanding lung function parameters such as airway resistance and intrathoracic gas volume is crucial for evaluating the effects of these medications. Objective: This study aimed to investigate the effect of combining the adenosine receptor blocker, bamifylline, with the anticholinergic substance, ipratropium bromide spray, in patients with bronchial asthma. Specifically, the study sought to assess changes in lung function parameters, including airway resistance and intrathoracic gas volume, after administering ipratropium bromide alone and in combination with bamifylline. Methods: Sixteen patients with bronchial asthma were enrolled in the study. Lung function was evaluated using body plethysmography, with measurements of airway resistance (Raw), intrathoracic gas volume (ITGV), airway specific resistance (SRaw), and airway specific conductance (SGaw). Patients initially received ipratropium bromide inhalation (2 inhalations x 20µg), followed by Raw and ITGV measurements at intervals (5, 30, 60, and 120 minutes). Subsequently, patients received bamifylline (2 x 600 mg) daily for seven days at home. On the eighth day, they were administered ipratropium bromide spray (2 inhalations x 20µg), and lung function parameters were assessed similarly. Results: Administration of ipratropium bromide alone led to a significant reduction in airway resistance (p<0.05). However, the combination of ipratropium bromide with bamifylline did not significantly enhance the effects of adenosine receptor blockade (p<0.05). Specifically, there were no significant changes in Raw, ITGV, SRaw, or SGaw after combining ipratropium bromide with bamifylline. Conclusion: The study findings suggest that the addition of anticholinergic substances did not potentiate the action of adenosine receptor blockers in patients with bronchial asthma. Therefore, the anti-inflammatory effects of xanthines, such as bamifylline, were not augmented by anticholinergic substances in this study. These results highlight the need for further research to explore alternative therapeutic approaches in the management of bronchial asthma.

Keywords: Atrovent (ipratropium bromide); Bronchial asthma; Bamifix (bamifylline)

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