Anticholinergic Medications for the Treatment of Chronic Obstructive Pulmonary Disease
نویسنده
چکیده
burden of COPD and that they address any demographic disparities in patients’ use of resources. These data would help clinicians and other health care professionals in developing disease-management programs that best suit a specific population. Bronchodilators are the mainstay for managing the symptoms of COPD. They may be prescribed on an as-needed basis at early stages of disease, but typically they should be given as scheduled maintenance therapy in patients with persistent symptoms. Some bronchodilators are delivered by metered-dose inhalers (MDIs) that contain chlorofluorocarbons (CFCs) as propellants. However, the Montreal Protocol on Substances that Deplete the Ozone Layer, which has been signed by more than 165 countries, calls for the phased withdrawal of CFCcontaining MDIs. Accordingly, many COPD patients will need to be switched to newer formulations and delivery systems. Most recently, ipratropium bromide (Atrovent HFA [hydrofluoroalkane], Boehringer Ingelheim) has become available in a CFC-free MDI, and a once-daily anticholinergic, tiotropium (Spiriva, Boehringer Ingelheim), is available as a dry powder. The advent of these new formulations provides an opportune time to reassess inhaled anticholinergic therapies in COPD. Combination products containing ipratropium plus the shortacting beta2-agonist albuterol sulfate are also available in the U.S. for treating COPD: Combivent (Boehringer Ingelheim) and DuoNeb (Dey, LP).
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