The role of anticholinergic bronchodilators in adult asthma and chronic obstructive pulmonary disease |
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Authors: | Chapman K R |
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Institution: | (1) Division of Respiratory Medicine, Toronto Western Hospital and Department of Medicine, University of Toronto, Toronto, Ontario, Canada |
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Abstract: | Our renewed interest in anticholinergic bronchodilator therapy has been sparked by the development of safe yet effective quaternary
anticholinergic compounds including ipratropium bromide, oxitropium and atropine methonitrate. These agents offer gradual
and sustained bronchodilatation to patients with asthma and to patients with COPD. However, their role in the maintenance
treatment of these two diseases differs significantly. In asthma, the anticholinergic drugs have useful additive properties
when used with adrenergic drugs or theophylline. They may be a particularly useful component of combination regimens in patients
with disease of more than mild severity and in older patients. The combination of inhaled adrenergic and anticholinergic drugs
is also useful in the acute setting for acute exacerbations of asthma. In chronic obstructive lung disease, the anticholinergic
compounds offer greater bronchodilatation than adrenergic drugs for the majority of patients. Thus, the inhaled anticholinergic
drugs may be considered as useful initial choices in the chronic maintenance therapy of COPD. |
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Keywords: | Quaternary anticholinergic Asthma COPD |
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