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Respiratory Stimulant Use in Chronic Obstructive Pulmonary Disease

OBJECTIVE To evaluate the use of respiratory stimulants in chronic obstructive pulmonary disease (COPD). DATA SOURCES MEDLINE (1966–July 2003) and EMBASE (1980–3rd quarter 2003) were searched using the search terms medroxyprogesterone acetate, acetazolamide, chronic obstructive pulmonary disease, and chronic obstructive lung disease. DATA SYNTHESIS Trials are reviewed evaluating ventilatory parameters with acetazolamide and/or medroxyprogesterone in patients with COPD. All studies found improvements in ventilatory parameters, but failed to demonstrate improvements in survival or quality of life. CONCLUSIONS Significant improvement in arterial blood gas and ventilatory parameters was reported in COPD patients after acetazolamide and medroxyprogesterone treatment; however, with no improvement in survival or quality of life, the place of these drugs in therapy remains unknown.