• Journal of Yeungnam Medical Science
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• v.24 no.2
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• pp.305-310
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• 2007

Background : After sinus surgery, airway dryness is made worse because patients breathe by mouth. Anticholinergic agents have antisialogogue effects. The airway dryness that occurs after surgery is severe and can increase the incidence of postoperative sore throat. Materials and Methods : One-hundered patients who were scheduled for endoscopic sinus surgery(ESS) were divided into four groups. Each group was premedicated with glycopyrrolate or had no premedication and reversed with glycopyrrolate or atropine. After the surgery the patients were asked about a sore throat and hoarseness postoperatively after 1h, 6h, 12h, 24h, and 48hours, respectively. Results : The incidence of postoperative sore throat and hoarseness was not significantly different among the four groups at any time. Conclusion : The severity of complications after ESS was low and subsided within 24 hours. Therefore, the use of anticholinergic agents does not need to be limited.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.2
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• pp.241-246
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• 1999

Delirium is a syndrome characterized by impairement of consciousness, disorientation, disturbance of sleep-wake cycle, memory impairement, disturbance of perception. It is induced by many causes, which are CNS diseases(head trauma, vascular disease, brain tumor, etc), medical diseases(metabolic disorder, endocrine disturbance, cardiovascular disease) and drugs(anticholinergics, anticonvulsant, antipsychotics, cimetidine etc). Transdermal scopolamine which is usually used to prevent motion sickness has anticholinergic property, and so it can induce delirium. The authors report two cases of delirium induced by transdermal scopolamine. The cases shared common characteristics which were as follows : 1. All of two patients were elderly women. 2. Delirium symptom was abruptly occurred during trip after attaching scopolamine patches. 3. Delirium symptom was rapidly improved within 2-3 days. It is important to educate for both users and managers about directions for transdermal scopolamine patch usage to prevent delirium. And careful history taking is needed to diagnose delirium induced by transdermal scopolamine accurately.

• Tuberculosis and Respiratory Diseases
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• v.58 no.5
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• pp.498-506
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• 2005

Background : This study compared the bronchodilator efficacy and safety of tiotropium inhalation capsules ($18{\mu}g$ once daily) with a ipratropium metered dose inhaler (2 puffs of $20{\mu}g$ q.i.d.) in patients with chronic obstructive pulmonary disease (COPD). Method : After the initial screening assessment and a two-week run-in period, patients received either tiotropium $18{\mu}g$ once daily or ipratropium $40{\mu}g$ four times daily over a period of 4 weeks in a double blind, double dummy, parallel group study. The outcome measures were the lung function, the daily records of the peak expiratory flow rate (PEFR), the patients' questionnaire, and the use of concomitant salbutamol. The forced expiratory volume in one second ($FEV_1$) and the forced vital capacity (FVC) were measured 5 minutes before inhalation, and 0.5, 1, 2 and 3 hours after inhaling the study drug on days 0, 14 and 28. Result : In 16 centers, 134 patients with a mean (SD) age of 66 (7) years and a predicted $FEV_1$ of 42 (12)% were analyzed. The trough $FEV_1$ response was significantly higher in the tiotropium group than in the ipratropium group after a four-week treatment period. The weekly mean morning PEFR of the tiotropium group was consistently higher than that of the ipratropium group during the 4-week treatment period with differences ranging from 12.52 to 13.88 l/min, which were statistically significant. Tiotropium was well tolerated by the COPD patients during the 4-week treatment period and had a similar safety profile to ipratropium. Conclusion : This study shows that tiotropium administrated once daily has a superior bronchodilator effect with a similar safety profile in treating COPD patients compared with ipratropium, inhaled four times daily.