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Clinical Investigations: Airways IrwaysEffect of 30 mg of Morphine Alone or With Promethazine or Prochlorperazine on the Exercise Capacity of Patients With COPD
Section snippets
Patient Selection
Inclusion criteria for the study included an FEV1 below 1.4 L, an FEV1/FVC below 0.50, exercise-limited by breathlessness, and a stable disease state. Patients were excluded if they met any of the following criteria: (1) PaCO2 above 45 mm Hg; (2) long-term oxygen therapy; (3) known cardiac disease, including left ventricular dysfunction, previous myocardial infarction, angina pectoris, arrhythmias requiring pharmacologic therapy, or hypertension requiring more than low-dose diuretic therapy;
Results
The characteristics of the seven male patients who completed the primary study are shown in Table 1. The average patient was elderly with severe COPD. The exercise capability was severely reduced with a mean of 990±315 mL/min and a mean maximal workload of less than 50 W. The patients appeared to be ventilatory limited since the mean maximal ( )/FEV1 was 36.5, the mean respiratory exchange ratio (R) was less than 1.00, the mean Borg score at Emax was 8.1, and
Discussion
The present study demonstrates that after the oral administration of 30 mg of M and 25 mg of P, there is a significant improvement in the exercise tolerance of patients with COPD. The improvement is greater than with 30 mg of M alone, 25 mg of P alone, or with 30 mg of M and 10 mg of PC. The M-P regimen did not appear to significantly affect the mental function or the motor coordination of the patient.
The improvement in the exercise tolerance after M-P is comparable to that which we reported
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Presented in part at the annual meeting of the American Thoracic Society, Boston, May 1990.
Supported in part by the Research Service of the Department of Veterans Affairs, The Purdue Frederick Company, and Wyeth-Ayerst Laboratories.