title: Biochemical properties, pharmacokinetics and pharmacological response of tiotropium in chronic obstructive pulmonary disease patients.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is a progressive disease with increasing incidence and mortality. Tiotropium is an inhaled long-acting anti-cholinergic for the maintenance treatment of COPD.
  
  
  OBJECTIVE
  To review biochemical and pharmacokinetic data on tiotropium and discuss in the context of tiotropium's efficacy and safety in COPD.
  
  
  METHODS
  Review of previously done pharmacokinetic studies performed by the manufacturer of tiotropium. Data obtained through peer-reviewed publications and regulatory websites.
  
  
  CONCLUSIONS
  The long duration of action with tiotropium is owing to prolonged, competitive binding to M(3) muscarinic receptors. Tiotropium is poorly absorbed following inhalation, which largely limits side effects. Metabolism of absorbed drug is minimal and excretion is largely through the kidneys. Tiotropium is efficacious and well tolerated by patients with COPD.
authors.affiliation: University of Aberdeen, Foresterhill Health Centre, Department of General Practice and Primary Care, Westburn Road, Aberdeen AB25 2AY, UK. david@respiratoryresearch.org
authors.forename: David
authors.initials: D
authors.lastname: Price
authors.forename: Ashish
authors.initials: A
authors.lastname: Sharma
authors.forename: Frank
authors.initials: F
authors.lastname: Cerasoli
mesh_terms: D000280:Administration, Inhalation; D000818:Animals; D001993:Bronchodilator Agents / Q000737:chemistry / Q000493:pharmacokinetics / Q000494:pharmacology; D006801:Humans; D011485:Protein Binding / Q000187:drug effects / Q000502:physiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000378:metabolism*; D011976:Receptors, Muscarinic / Q000378:metabolism; D012602:Scopolamine Derivatives / Q000737:chemistry / Q000493:pharmacokinetics* / Q000494:pharmacology*; D000069447:Tiotropium Bromide
chemical_list: D001993:Bronchodilator Agents; D011976:Receptors, Muscarinic; D012602:Scopolamine Derivatives; D000069447:Tiotropium Bromide