title: Anticholinergics/antimuscarinic drugs in asthma.
abstract: Anticholinergic alkaloids have been used for thousands of years for the relief of bronchoconstriction and other respiratory symptoms, and their use in the treatment of chronic obstructive pulmonary disease is well established. Acetylcholine, acting through muscarinic receptor (M) receptor, modulates multiple physiologic functions pertinent to asthma including airway muscle tone, mucus gland secretion, and various parameters of inflammation and remodeling. In addition, activation of M receptors may inhibit beta2 adrenoreceptor. These observations offer the rationale for the use of M receptors antagonists in the treatment of asthma. Short-acting antimuscarinic agents may be effective alone or in combination with short-acting beta agonists for the relief of acute symptoms. Long-acting antimuscarinic agents have emerged as potentially useful in the long-term treatment of difficult-to-control asthma. This review will analyze the mechanisms of action and therapeutic role of antimuscarinic agents on asthma including current guidelines regarding antimuscarinic drugs, recent studies in asthma, special populations to consider, and possible predictors of response.
authors.affiliation: Department of Medicine, University of California, 200 West Arbor Dr., San Diego, CA, 92103, USA.
authors.forename: Xavier
authors.initials: X
authors.lastname: Soler
authors.forename: Joe
authors.initials: J
authors.lastname: Ramsdell
mesh_terms: D001249:Asthma / Q000188:drug therapy*; D018680:Cholinergic Antagonists / Q000627:therapeutic use*; D006801:Humans; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*
chemical_list: D018680:Cholinergic Antagonists; D018727:Muscarinic Antagonists