Tiotropium Bromide: An Update

Josep Lluis Heredia, * Open Modal Authors Info & Affiliations
The Open Respiratory Medicine Journal 14 Apr 2009 RESEARCH ARTICLE DOI: 10.2174/1874306400903010043


Tiotropium bromide is a once-daily inhaled anticholinergic bronchodilator. It works by blocking the muscarinic receptors in airway smooth muscle. Tiotropium has a wide therapeutic margin, due to its poor gastrointestinal absorption and its very low systemic bioavailability. The drug is mainly indicated in COPD patients. Clinically relevant outcomes such as significant improvements in spirometry, hyperinflation, dyspnea, heath status, acute exacerbations and mortality have been consistently observed in tiotropium clinical trials, and the drug has been shown to reduce the risk of mortality due to cardiac-vascular disease and respiratory failure. The main side effect reported is dryness of the mouth. Some subgroups of asthmatics also seem to respond to anticholinergic drugs: among them, those with the Arg/Arg genotype for the β2-adrenergic receptor and those with a high percentage of neutrophils in sputum.

Keywords: Tiotropium bromide, COPD, lung function, COPD mortality, COPD exacerbations, quality of life..
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