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Medical Author:

George Schiffman, MD, FCCP

George Schiffman, MD, FCCP

Dr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Ipratropium bromide (Atrovent) and tiotropium (Spiriva) are used with beta-agonists for severe symptoms.

How anticholinergic inhalers work

These drugs decrease bronchospasm and secretion of mucus in airways and are often used with albuterol to enhance effectiveness. In general, they are not as effective as the beta-agonists in treating asthma.

Who should not use these medications

• Individuals who are allergic to any components of the inhaled product should not take these drugs.



• Individuals who are allergic to soya lecithin or similar food products, such as soybeans or peanuts, should not take these drugs.

Use

Both handheld inhalers and a solution for use with a nebulizer are available. Many inhaled products have specific devices and you should be thoroughly informed on how to use the inhaler or nebulizer prescribed for you. These drugs are typically used three to four times per day.

Drug or food interactions

Since anticholinergic inhalers have little or no effect beyond the area applied, they are unlikely to interact with other drugs.

Side effects

Anticholinergic inhalers are not indicated for acute asthma attacks. The most common adverse effect is dry mouth. Individuals with glaucoma should be closely monitored by their ophthalmologist.

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