caa a22 4500 475817877 CHVBK 20180406123814.0 cr unu---uuuuu 170329e20000101xx s 000 0 eng 10.1007/s002280050005 doi (NATIONALLICENCE)springer-10.1007/s002280050005 Verapamil causes decreased diaphragm endurance but no decrease of nocturnal O2 saturation in patients with chronic obstructive pulmonary disease [Elektronische Daten] [M. E. A. C Broeders, Y. F. Heijdra, P. Smits, H. T. M. Folgering, C. Kramers] Objective: In animal studies, it has been shown that verapamil reduces strength and endurance of the diaphragm and inhibits the beneficial effects of theophylline. We examined whether the use of verapamil in patients with severe chronic obstructive pulmonary disease (COPD) who use theophylline leads to a deterioration of diaphragmatic function resulting in a decrease of nocturnal O2 saturation. Methods: A double-blind, placebo-controlled crossover study was designed in eight stabile severe COPD patients [forced expiratory volume in 1 s (FEV1) 0.9 ± 0.1 l] taking theophylline. The doses of theophylline ranged from 600 mg daily to 1200 mg daily (7.0 mg/kg daily to 16.9 mg/kg daily). Nocturnal recordings, maximal respiratory muscle strength and endurance tests, lung function, blood pressure, electrocardiogram and arterial blood gas analysis were performed after 6 days of verapamil and after placebo. Results: A significant decrease of the endurance time from 7.7 min to 6.4 min was found in the threshold loading test. However, the mean nocturnal saturation values did not change significantly: 89.8% and 89.6%, respectively. Results of pulmonary function tests, arterial blood gas analysis and routine blood samples also did not change. Conclusion: The decrease of the respiratory muscle endurance after the use of verapamil is in line with experiments in animal diaphragms. However, the nocturnal saturation did not change. This finding suggests that the effect found on diaphragm endurance is of no clinical significance and that verapamil can be given to COPD patients without risk of worsening nocturnal saturation. However, this must be confirmed by future larger scale studies. Springer-Verlag Berlin Heidelberg, 2000 Key words Chronic obstructive pulmonary disease nationallicence Calcium antagonists nationallicence Diaphragm nationallicence Broeders M. E. A. C. Department of Pulmonary Diseases Dekkerswald, University of Nijmegen, P.O. Box 9001, 6560GB Groesbeek, The Netherlands e-mail: m.broeders@mailbox.kun.nl, NL aut Heijdra Y. F. Department of Pulmonary Diseases Dekkerswald, University of Nijmegen, P.O. Box 9001, 6560GB Groesbeek, The Netherlands e-mail: m.broeders@mailbox.kun.nl, NL aut Smits P. Department of Pharmacology, University of Nijmegen, P.O. Box 9101, 6500HB Nijmegen, The Netherlands, NL aut Folgering H. T. M. Department of Pulmonary Diseases Dekkerswald, University of Nijmegen, P.O. Box 9001, 6560GB Groesbeek, The Netherlands e-mail: m.broeders@mailbox.kun.nl, NL aut Kramers C. Department of Pharmacology, University of Nijmegen, P.O. Box 9101, 6500HB Nijmegen, The Netherlands, NL aut https://doi.org/10.1007/s002280050005 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002280050005 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Broeders M. E. A. C. Department of Pulmonary Diseases Dekkerswald, University of Nijmegen, P.O. Box 9001, 6560GB Groesbeek, The Netherlands e-mail: m.broeders@mailbox.kun.nl, NL aut NATIONALLICENCE 700 1- Heijdra Y. F. Department of Pulmonary Diseases Dekkerswald, University of Nijmegen, P.O. Box 9001, 6560GB Groesbeek, The Netherlands e-mail: m.broeders@mailbox.kun.nl, NL aut NATIONALLICENCE 700 1- Smits P. Department of Pharmacology, University of Nijmegen, P.O. Box 9101, 6500HB Nijmegen, The Netherlands, NL aut NATIONALLICENCE 700 1- Folgering H. T. M. Department of Pulmonary Diseases Dekkerswald, University of Nijmegen, P.O. Box 9001, 6560GB Groesbeek, The Netherlands e-mail: m.broeders@mailbox.kun.nl, NL aut NATIONALLICENCE 700 1- Kramers C. Department of Pharmacology, University of Nijmegen, P.O. Box 9101, 6500HB Nijmegen, The Netherlands, NL aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer