[Clinico-functional study of the activity of a new xanthine derivative: bamifylline].
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Biomedical subjects
Publications and source records attributed to G C Morandini.
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In order to explain the mechanism of action of drugs modifying the bronchial secretions, their subdivision into agents with a direct or an indirect action seems justified: the former primarily modify already formed secretions, whilst the latter act on the bronchial structures originating mucus. In hypersecretive states with increased viscoelasticity of mucus, a widespread therapy is represented by the use of direct reducing drugs, which act by breaking the mucofibrillar network. Among them the most important are those with free sulphydryl groups (-SH), which can break the disulphide bonds of the bronchial secretions. The mechanism of action of substances such as acetylcysteine and tiopronin, that are included in those with a direct reducing action, was already verified by researches with the modified thrombo-elastograph (MTE) and has been recently confirmed by the present authors by employing a simple biochemical method, by which the action of such drugs on the structure of serum IgM can be studied in vitro. The same method permits the classification of carbocisteine and letosteine as amongst the drugs with indirect action. From the results obtained by such in vitro experiences, the necessity to examine more closely the consequences of secondary effects which direct mucolytic agents may cause by modifying the rheological, biochemical and immunological properties of bronchial secretions has been demonstrated.
A comparative trial conducted on 48 male and 9 female patients suitably selected in terms of indication consisted of a first stage in which a completely random, doubleblind comparison was made between acetylsalicylic acid, guacetisal and guaiacol carbonate (preparations A, B, and C) while in the second stage an association of bromexine, acetylsalicylic acid and codeine phosphate (preparation D) was examined in terms of activity and tolerance in an open trial. Statistical analysis showed the superiority of preparation B with respect to most of the parameters taken into consideration.
This work deals with a modification of a thromboelastograph which enables to measure both in vitro and in vivo effectiveness of mucolytic substances. A simple method is described for building up a comparative diagram of the effectiveness of several drugs; a diagram which is of interest from both a pharmacological and a clinical point of view.
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In 69 out-patients with chronic bronchitis in 6 centres the effects of acetylcysteine 600 mg daily, 3 days a week for 6 months, and a placebo have been compared in a double-blind controlled trial. Thirty-five patients were treated with the mucolytic and 34 with the dummy preparation. In the former the clinical course of the chronic bronchitis improved to a greater extent and a significantly lower number of exacerbations was observed. The advantages of long-term oral treatment with the mucolytic in chronic bronchitis suggest that it may be useful as an alternative to long-term antibiotic prophylaxis, or to complement brief courses of antibiotics, in addition to the usual physiotherapy.
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A technique and an original apparatus for recording and displaying the sound levels emitted by human lungs during respiratory movements are described. By means of it a graphic recording of chest acoustics can be obtained. An analysis of the phonopneumographic findings shows clear differences between normal pathological readings, both in the level of the sounds and in their frequency content. Evidence is given of cases in which the physician can directly recognize the presence of special diseases. Beside this, FPGraphic representations are also useful for retaining evidence of findings which cannot be recorded by other methods, and for checking the natural evolution of a disease or its response to clinical treatments.
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