Fármacos anticolinérgicos

Because cholinergic activity contributes to airway narrowing in patients with chronic obstructive pulmonary disease (COPD), anticholinergic agents are the treatment of choice of chronic airway obstruction in these patients. Tiotropium, a long-acting anticholinergic agent with a marked affinity for the M3 receptor, allows once-daily dosing, which, together with the absence of adverse effects and the lack of tachyphylaxis, favors compliance and makes this drug the treatment of choice in stable COPD. This drug has been demonstrated to have several beneficial effects such as a bronchodilatory effect (with improvement of forced expiratory volume in 1 second and forced vital capacity), reduction of lung hyperinflation and the number, intensity and severity of acute COPD exacerbations, and improvement of dyspnea, exercise tolerance and healthrelated quality of life. The association of this drug with longacting beta-2 agonists and its effect on airflow reduction seem to be its most promising actions.