How Do Inhaled Anticholinergics Work?

Inhaled anticholinergics are medications used to dilate and decongest the bronchial passages in patients with chronic obstructive pulmonary disease (COPD). Anticholinergics block the activity of acetylcholine, a neurotransmitter that nerve endings secrete to make muscles contract.

Acetylcholine works by binding to protein molecules known as muscarinic receptors on the surface of muscle cells to make them contract. Acetylcholine also stimulates muscarinic receptors on exocrine gland cells to secrete fluids such as mucus, saliva, tears, and sweat.

Also known as long-acting muscarinic antagonists (LAMA), inhaled anticholinergics block the muscarinic receptors on the bronchial smooth muscles and the exocrine gland cells in the bronchial passage. Blocking acetylcholine activity in the airway relaxes the airway muscles, reduces mucus congestion, and eases breathing.

Inhaled anticholinergics are solutions that are orally inhaled using a nebulizer that changes the solution into a fine mist. Inhaled anticholinergics are used for the long term in the maintenance treatment of chronic obstructive pulmonary disease to relieve symptoms such as shortness of breath, wheezing, and cough.

Side effects of inhaled anticholinergics may include the following:

• Cough
• Nasopharyngitis (inflammation of nose and throat)
• Headache
• Upper respiratory tract infection
• Back pain
• Hypertension (high blood pressure)
• Dizziness
• Oropharyngeal pain (mouth and throat pain)
• Bronchitis (inflammation of bronchial passage)
• Paradoxical bronchospasm
• Worsening of narrow-angle glaucoma (an eye condition that damages the optic nerve)
• Worsening of urinary retention
• Immediate hypersensitivity reactions

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of an inhaled anticholinergic drug are:

• revefenacin
• Yupelri