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Inhalation therapy is a major method of treatment of COPD. Bronchodilator as a first-line treatment for COPD symptoms; ICS for stable COPD (Ⅲ and Ⅳ) and COPD acute exacerbation (AECOPD) have a clear indication. It has been demonstrated that the combination of different mechanisms of action and time of action is superior to their respective monotherapies such as anticholinergics in combination with β2 agonists and ICS in combination with LABA. At present, tiotropium bromide(136310-93-5) is an effective bronchodilator for patients with moderate to severe COPD, and tiotropium combined with formoterol is more effective in COPD.

Since the introduction of ipratropium bromide in 1980, anticholinergics have become the standard treatment for chronic obstructive pulmonary disease (COPD). At present, all levels of COPD guidelines recommend ipratropium bromide, but its duration of action is only 4 ~ 6h, many times a day administration easily lead to poor patient compliance. Tiotropium bromide(136310-93-5) is a synthetic achiral quaternary ammonium anticholinergic drug, there are two characteristics: (1) regulation of airway smooth muscle contraction M receptor is highly selective; (2) the role of a long time, only a day to drug 1 times. In 2002, tiotropium bromide(136310-93-5) was used in some countries except the United States. In January 2004, the United States formally approved the use. Because of its unparalleled advantages, the drug in clinical more and more popular. This review focuses on the pharmacological effects, clinical efficacy and safety of tiotropium bromide.

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