The anticholinergic compounds are potent bronchodilators. We will not consider atropine, which is no longer used, but its congener, ipratropium, less prone to side effects. This agent acts by blocking muscarinic receptors. It has a complementary role to other bronchodilators such as beta-agonists and theophylline. In stable asthmatic patients, it may be that ipratropium is less potent than beta-adrenergic agents. In patients with chronic bronchitis and emphysema, it is a potent bronchodilator. Although the place of ipratropium is still discussed in acute asthma and COPD, this agent adds significantly to the level and duration of bronchodilatation by its combination with other bronchodilators.
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