Abstract
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▴ Tiotropium bromide is an anticholinergic bronchodilator that antagonises muscarinic M1, M2 and M3 receptors. It dissociates more slowly from M1 receptors and, importantly, from M3 receptors (which are located in bronchial smooth muscle) than from M2 receptors and subsequently has a long duration of action permitting once-daily administration.
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▴ In patients with chronic obstructive pulmonary disease (COPD), tiotropium 18μg once daily significantly improved lung function compared with placebo and ipratropium 40μg four times daily in 1-year trials or salmeterol 50μg twice daily in a 6-month study.
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▴ The incidence of COPD exacerbations decreased and use of rescue medication was lower with tiotropium compared with placebo or ipratropium. There was no evidence of tachyphylaxis during 1-year treatment with tiotropium.
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▴ Compared with placebo, salmeterol and ipratropium, tiotropium produced significant improvements in patients’ perception of dyspnoea and health-related quality of life.
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▴ Tiotropium is generally well tolerated; dry mouth is the most common drug-related adverse event, occurring in about 10 to 16% of patients in clinical trials.
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Hvizdos, K.M., Goa, K.L. Tiotropium Bromide. Drugs 62, 1195–1203 (2002). https://doi.org/10.2165/00003495-200262080-00008
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DOI: https://doi.org/10.2165/00003495-200262080-00008