title: Safety of long acting muscarinic antagonists: are all these drugs always and equally safe?
abstract: Inhaled bronchodilators - such as long-acting muscarinic receptor antagonists (LAMAs) - are central to the pharmacological management of symptomatic chronic obstructive pulmonary disease. LAMAs are considered to be safe drugs at recommended dosages. In the present issue of the Journal safety of umeclidinium, a recently marketed LAMA, at twice the recommended dosage, has been evaluated with good results in a Japanese, COPD population. However, because muscarinic receptors are expressed not only in the lungs but also at the level of heart, digestive and urinary apparatus, the potential exists for LAMAs to cause adverse events related to stimulation of receptors in these organs. Head-to-head and post-marketing vigilance studies are required to determine the profile risk of these drugs, ultimately, and whether differences exist between currently available LAMAs.
authors.affiliation: a Respiratory Rehabilitation and Pathophysiology Unit, Cardiovascular and Lung Department , Policlinico le Scotte, Azienda Ospedaliera Universitaria Senese , Siena , Italy ;
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Melani
authors.affiliation: b Respiratory Disease Clinics, Siena University, Policlinico le Scotte, Azienda Ospedaliera Universitaria Senese , Siena , Italy.
authors.forename: Piersante
authors.initials: P
authors.lastname: Sestini
mesh_terms: D000280:Administration, Inhalation; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D018727:Muscarinic Antagonists / Q000009:adverse effects*; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D011812:Quinuclidines / Q000009:adverse effects*
chemical_list: D001993:Bronchodilator Agents; C573971:GSK573719; D018727:Muscarinic Antagonists; D011812:Quinuclidines
keywords: COPD; Chronic obstructive pulmonary disease; LAMAs; Long-acting muscarinic receptor antagonists; Potential adverse events