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Clin Chest Med. 2014 Mar;35(1):191-201. doi: 10.1016/j.ccm.2013.10.005. Epub 2013 Dec 12.

Bronchodilators: current and future.

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Unit of Respiratory Clinical Pharmacology, Department of System Medicine, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy. Electronic address:
Unit of Pharmacology, Department of Experimental Medicine, Second University of Naples, Naples, Italy.


Bronchodilators are central in the symptomatic treatment of chronic obstructive pulmonary disease (COPD), although there is often limited reversibility of airflow obstruction. Three classes of bronchodilators (β2-agonists, antimuscarinic agents, methylxanthines) are currently available, which can be used individually, or in combination with each other or inhaled corticosteroids. Novel classes of bronchodilators have proved difficult to develop. The muscarinic β2-agonist molecules approach likely provides the best opportunity to develop combinations that combine corticosteroids with dual-bronchodilator activities, and thus potentially achieve better efficacy than is apparent with the current combination products that dominate the treatment of COPD.


Antimuscarinic agents; Choice of bronchodilators; Chronic obstructive pulmonary disease; Emerging bronchodilators; Methylxanthines; β(2)-Agonists

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