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Inhalation-type anticholinergic drugs include ipratropium bromide, tiotropium bromide(136310-93-5) and etc.

Tiotropium bromide(136310-93-5): is a long-term anti-cholinergic drugs, mainly by inhibiting the smooth muscle cells on the M3 receptor, resulting in persistent bronchodilation. Currently available in the country is mainly powder inhalation agent, the use of portable inhalation device (suction music, HandiHaler) inhalation, more suitable for COPD patients after discharge of long-term maintenance treatment to improve symptoms and prevent acute exacerbation of COPD. 

At present, the clinical still glucocorticoids, α-chymotrypsin, aminophylline, gentamicin and other as inhalation drugs used. It should be recognized that dexamethasone has limited local efficacy and large side effects; α-chymotrypsin inhalation can lead to airway epithelial squamous metaplasia; gentamicin to stimulate the airway mucosa, and atomization inhalation of ammonia theophylline has a significant effect on airway mucosa. 

In short, the "high reactivity hyper-high resistance state" is the basic pathophysiological changes in bronchial spasm, will increase the risk of perioperative pulmonary complications. Various causes of increased vagal tone in which play an important role. Perioperative inhalation of anticholinergic drugs such as ipratropium bromide, can effectively reduce the vagus nerve tension, relieve hyperresponsiveness of high-stress state, prevention of bronchial spasm and other perioperative pulmonary complications, is to protect patients "fast Rehabilitation "one of the important measures.

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