Anticholinergic agents in asthma and COPD

• Published in: European journal of pharmacology Vol. 533; no. 1-3; pp. 36 - 39
• Main Author: Gross, Nicholas J.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 08.03.2006
• Subjects: Antimuscarinic agent; Asthma; Asthma - drug therapy; Bronchodilator Agents - adverse effects; Bronchodilator Agents - therapeutic use; Cholinergic Antagonists - adverse effects; Cholinergic Antagonists - therapeutic use; Clinical Trials as Topic; COPD (Chronic Obstructive Pulmonary disease); Humans; Ipratropium; Ipratropium - adverse effects; Ipratropium - therapeutic use; Muscarinic receptor; Pulmonary Disease, Chronic Obstructive - drug therapy; Scopolamine Derivatives - adverse effects; Scopolamine Derivatives - therapeutic use; Tiotropium; Tiotropium Bromide; Tiotropium; Muscarinic receptor; Ipratropium; Antimuscarinic agent; COPD (Chronic Obstructive Pulmonary disease); Asthma
• ISSN: 0014-2999; 1879-0712
• DOI: 10.1016/j.ejphar.2005.12.072

Anticholinergic agents have important uses as bronchodilators for the treatment of obstructive airway diseases, both asthma and, more particularly, chronic obstructive pulmonary disease (COPD). Those in approved clinical use are synthetic quaternary ammonium congeners of atropine, and include ipratropium bromide, oxitropium bromide, and tiotropium bromide, each of which is very poorly absorbed when given by inhalation. Ipratropium and oxitropium have relatively short durations of action (4–8 h). They have been widely used for many years, either alone or in combination with short-acting beta-adrenergic agents such as albuterol and fenoterol, for both maintenance treatment of stable disease and for acute exacerbations of airway obstruction. Tiotropium, which was introduced in the early 2000s, has a duration of action of at least 1–2 days making it suitable for once-daily maintenance treatment of COPD. All of the above agents have a wide therapeutic margin and are safe and well tolerated by patients.