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SELECTED ARTICLES FROM THE RECENT LITERATURE 2006
12/8/06
Treatment with anticholinergics in asthma and COPD
Summary
Background – Inhaled anticholinergics (IAC) have been used in the treatment of COPD, and asthma to a lesser extent, for many years. However, recently available newer IAC agents bear review and comment.
Findings – Gross of the VA Hospital in Hines, IL reviewed this subject. IAC approved by the FDA for clinical use are generally quarternary ammonium congeners of atropine. The earlier agents (ipratropium, oxitropium) are relatively short acting (4-8 hours) while tiotropium has a duration of effect of 1-2 days, allowing for once daily use either alone or in combination with inhaled beta agonists.
These agents have been used in the maintenance therapy of persistent asthma and in some cases of acute exacerbations.
Reference
Eur J Pharmacol 2006;533:36-9
Editor's Comments
IAC may be as effective as inhaled beta agonists (IBA) in asthma, particularly in children. IAC agents have never received the attention conferred on IBA in the management of asthma. This lack of interest may have been due to drying effects of IAC in the oropharynx. It is unclear how much additive beneficial effect is observed when IAC and IBA are used in combination. IAC may be of particular value in treating the minority of asthmatics who experience a paradoxic worsening effect of inhaled albuterol.
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