Anticholinergic bronchodilators

Antimuscarinic treatment of airway disease has a long and colorful history leading to its present day use as an effective bronchodilator in chronic obstructed pulmonary disease (COPD) as well as an antisecretory drug for watery rhinorrhea. Present formulations are limited to ipratropium bromide, a safe and effective respiratory therapeutic. The bronchodilation from ipratropium, as documented by spirometry, has been well established both alone and in combination with albuterol. Evidence suggests that anticholinergics can affect other important aspects of COPD, such as dynamic hyperinflation, and further studies are warranted to confirm long-term physiologic effects and associated health outcomes. Finally, current development of the long-acting compound tiotropium has provided hope for the next generation of antimuscarinic agents represented by once-daily therapy.