Tiotropium is currently the long acting bronchodilator of choice for the treatment of stable COPD.
What is tiotropium?
Tiotropium (Spiriva) is a long acting, anticholinergic agent that is administered by inhalation. It provides sustained bronchodilation due to its prolonged occupancy of muscarinic M3 receptors in the airways, which causes smooth muscle relaxation. This allows the convenience of once daily dosing. (Tiotropium has equal efficacy for M1 to M5 receptors; bronchodilation is chiefly a local effect.)