Long-term and Short-term Effects of Oral Prethcamide in Chronic Ventilatory Failure

The effect of oral prethcamide (Micoren) (a mixture of two related amides of crotonyl N′ butyric acid) was compared with a placebo preparation in 13 patients with established chronic ventilatory failure. Part I of the study comprised a double-blind single cross-over trial with an initial assessment and two further assessments at the end of each period of one month. Prethcamide was taken in 200-mg. doses four times daily. No subjective or objective changes were noted, and in particular the resting Pco₂ showed no change.Part II of the study comprised a double-blind single cross-over trial of the short-term effect of prethcamide compared with placebo in 12 patients in chronic ventilatory failure. Frequent estimations of mixed venous Pco₂ were made with a rebreathing technique for four and a half hours after ingestion of prethcamide or placebo preparation.Following prethcamide a fall in Pco₂ level to a minimum value at 30 minutes of 93% of control values and persisting for about three hours was noted for the group as a whole. The fall represents a lowering by about 4 mm. Hg of the mixed venous Pco₂.It is concluded that, though in patients with chronic ventilatory failure prethcamide may reduce the Pco₂ in the short term, there is no subjective benefit or observable objective change following repeated administrations over a period of one month.