title: The role of anticholinergics in chronic obstructive pulmonary disease.
abstract: Anticholinergics are the bronchodilators of choice in the management of chronic obstructive pulmonary disease (COPD). They work by blocking muscarinic receptors in airway smooth muscle. Cholinergic tone appears to be the only reversible component of COPD. With the discovery of different muscarinic receptor subtypes, the development of more selective anticholinergics is possible. A major advance in this therapeutic area has been the discovery of tiotropium bromide, which has kinetic selectivity for M3 receptors as well as a duration of action of >24 hours. Once-daily administration of tiotropium is well tolerated and has shown significant advantages over ipratropium bromide, given 4 times daily, in the control of COPD.
authors.affiliation: Department of Thoracic Medicine, National Heart and Lung Institute, Imperial College, London, United Kingdom.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Barnes
mesh_terms: D001993:Bronchodilator Agents / Q000627:therapeutic use*; D018680:Cholinergic Antagonists / Q000627:therapeutic use*; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D012602:Scopolamine Derivatives / Q000627:therapeutic use*; D000069447:Tiotropium Bromide
chemical_list: D001993:Bronchodilator Agents; D018680:Cholinergic Antagonists; D012602:Scopolamine Derivatives; D000069447:Tiotropium Bromide