How Do Respiratory Anticholinergics Work?

Reviewed on 1/12/2022

How do respiratory anticholinergics work?

Respiratory anticholinergics are medications prescribed to treat chronic obstructive pulmonary disease (COPD) and asthma. Respiratory anticholinergics make breathing easier by relaxing the smooth muscles of bronchial tubes, improving lung function, and reducing mucus secretion in the respiratory system.

Some of the respiratory anticholinergics are combined with other medications that reduce hypersensitivity reaction in the respiratory system and reduce inflammation. Anticholinergics work by blocking the activity of acetylcholine, a neurotransmitter that nerve endings secrete to make muscles contract.

Acetylcholine binds 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.

Respiratory anticholinergics are long-acting muscarinic antagonists (LAMA), which relax airway smooth muscles and reduce mucus secretion by blocking muscarinic receptors on the bronchial smooth muscles and the exocrine gland cells in the bronchial passage.

Other medications combined with anticholinergics include:

  • Long-acting beta-2 agonists (LABAs): LABAs enhance the activity of beta-2 adrenergic receptors which are stimulated by epinephrine, a natural hormone in the body. Stimulation of beta-2 receptors results in intracellular action that relaxes bronchial muscles and inhibits hypersensitivity reaction from mast cells, a type of immune cells that initiate allergic reactions.
  • Corticosteroids: Corticosteroids are powerful anti-inflammatory agents used to control inflammation.

How are respiratory anticholinergics used?

Respiratory anticholinergics are orally inhaled in the form of powders, aerosolized tiny particles or droplets, or solutions nebulized into a fine mist. Many types of inhalation devices such as metered dose inhalers and nebulizers are available.

Respiratory anticholinergics are used to treat the following conditions:


  • Long term maintenance treatment of chronic obstructive pulmonary diseases including:
  • Long term maintenance treatment of asthma, an inflammatory bronchial condition


  • Acute asthma exacerbation

Orphan designation:

What are side effects of respiratory anticholinergics?

Side effects of respiratory anticholinergics may include the following:

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.

What are names of respiratory anticholinergic drugs?

Generic and brand names of respiratory anticholinergic drugs include:


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