title: Inhaled albuterol/salbutamol and ipratropium bromide and their combination in the treatment of chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality throughout the world. Combination therapy with albuterol and ipratropium bromide was approved > 15 years ago for the treatment of COPD. We review the mechanism of action, clinical efficacy, and safety of albuterol, ipratropium and combined albuterol-ipratropium therapy.
  
  
  METHODS
  We conducted a PubMed literature search using the keywords COPD, albuterol, ipratropium bromide and Combivent (Boehringer Ingelheim Corp., Ridgefield, CT, USA); pertinent references within the identified citations are included in the review. Data from the manufacturers are also evaluated.
  
  
  RESULTS
  At the time of its approval, albuterol/ipratropium bromide was an innovative combination of existing medications for the treatment of COPD. The combined formulation provides better improvement in airflow than either component alone and, by reducing the number of separate inhalers, simplifies therapy and improves compliance compared with the individual components.
  
  
  CONCLUSIONS
  The recent development and approval of longer acting and more potent beta agonists, anticholinergics and newer combination treatments have surpassed many of the advantages of combined albuterol-ipratropium for the treatment of patients with stable COPD.
authors.affiliation: Cincinnati Veterans Affairs Medical Center, Pulmonary, Critical Care, and Sleep Division, Cincinnati, OH 45220, USA.
authors.forename: Joshiah
authors.initials: J
authors.lastname: Gordon
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: Panos
mesh_terms: D000420:Albuterol / Q000009:adverse effects / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D000068600:Albuterol, Ipratropium Drug Combination; D001993:Bronchodilator Agents / Q000009:adverse effects / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D006801:Humans; D009241:Ipratropium / Q000009:adverse effects / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*
chemical_list: D000068600:Albuterol, Ipratropium Drug Combination; D001993:Bronchodilator Agents; D009241:Ipratropium; D000420:Albuterol