The influence of anticholinergic agents on treatment for bronchitis and emphysema.

Recent studies have shown that anticholinergic therapy is more effective than the most potent beta-adrenergic agents for chronic obstructive pulmonary disease. In the 3 years since it has been available to physicians in the United States, the quaternary anticholinergic drug ipratropium bromide (Atrovent) has had a considerable influence on clinical practice and the management of patients who have this disease. However, knowledge in this area is still incomplete. Questions remain as to the long-term effects of anticholinergic agents on the airways and, perhaps more important, on the natural progression of chronic obstructive pulmonary disease. Studies currently in progress will help determine the effect of prolonged therapy with anticholinergic agents on the progression and morbidity of lung disease.