Bronchodilators are central to COPD symptom management; current options include the anticholinergic ipratropium, short- and long-acting β2-agonists, and theophylline. Tiotropium which is not yet available in the United States, may become a useful addition to the armamentarium. Novel phosphodiesterase 4 inhibitors with both anti-inflammatory and bronchodilatory effects, including roflumilast, piclamilast, and cilomilast, are being investigated. Combination therapy with bronchodilators that have different mechanisms and durations of action may prove key in achieving the greatest symptom control with the fewest side effects. For example, prescribing a first-generation β2-adrenergic agonist, such as albuterol, together with an antimuscarinic agent is reasonable from the standpoints of both efficacy and safety.
|Original language||English (US)|
|Number of pages||13|
|State||Published - Jul 1 2003|
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