New therapies for chronic obstructive pulmonary disease.

tiotropium bromide provides long term bronc-There have been important advances in mus-Thoracic Medicine, National Heart and hodilatation and protection against cholinergic carinic receptor pharmacology with the re-Lung Institute, challenge in asthmatic subjects with effects lastcognition of several subtypes of muscarinic Imperial College, ing for more than three days. 11In studies of receptors in airways which appear to serve London SW3 6LY, UK patients with COPD tiotropium bromide gives P J Barnes different physiological functions. 4This has sugprolonged bronchodilatation lasting over 24 gested that more selective muscarinic ant-Correspondence to: Professor P J Barnes.agonists may have advantages over the existing hours. 12 13This suggests that tiotropium brom-