The development of anticholinergics in the management of COPD.
Anticholinergics have been used to treat obstructive respiratory disease for many years from historical preparations of the deadly nightshade genus, to the more recent developments ofipratropium, oxitropium, and tiotropium. The medical treatment of airways obstruction has focused on achieving maximal airway function through bronchodilators. Of the two main bronchodilators, beta2-agonists are often the first treatment choice although there is evidence of equivalence and some suggestions of the superiority of anticholinergics in chronic obstructive pulmonary disease (COPD). The following review looks at the background of anticholinergics, their pharmacological properties, and the evidence for use with suggestions for their place in the treatment of COPD.
University Hospitals of Leicester Glenfield Site, Institute for Lung Health, Leicester, UK. jane.scullion@uhl-tr.nhs.uk
Jane E
JE
Scullion
D018680:Cholinergic Antagonists / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D017079:Exercise Tolerance; D006801:Humans; D009241:Ipratropium / Q000627:therapeutic use; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D011788:Quality of Life; D043643:Receptor, Muscarinic M1 / Q000037:antagonists & inhibitors; D043585:Receptor, Muscarinic M2 / Q000037:antagonists & inhibitors; D043587:Receptor, Muscarinic M3 / Q000037:antagonists & inhibitors; D012602:Scopolamine Derivatives / Q000627:therapeutic use; D000069447:Tiotropium Bromide
D018680:Cholinergic Antagonists; D043643:Receptor, Muscarinic M1; D043585:Receptor, Muscarinic M2; D043587:Receptor, Muscarinic M3; D012602:Scopolamine Derivatives; C017590:oxitropium; D009241:Ipratropium; D000069447:Tiotropium Bromide