Biochemical properties, pharmacokinetics and pharmacological response of tiotropium in chronic obstructive pulmonary disease patients.
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.
Price
David
D
University of Aberdeen, Foresterhill Health Centre, Department of General Practice and Primary Care, Westburn Road, Aberdeen AB25 2AY, UK. david@respiratoryresearch.org
Sharma
Ashish
A
Cerasoli
Frank
F
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
D001993:Bronchodilator Agents; D011976:Receptors, Muscarinic; D012602:Scopolamine Derivatives; D000069447:Tiotropium Bromide