The role of anticholinergic antimuscarinic bronchodilator therapy in children.

In the intricate system of control of airway caliber, the cholinergic (muscarinic) sympathetic nervous system has an important role. Despite the paucity of physiologic or clinical data, it is clear that anticholinergic, antimuscarinic bronchodilator therapy is useful in the management of childhood airway disease. Ipratropium bromide is the only safe and adequately studied agent. It is effective in conjunction with beta-agonists in acute severe childhood asthma and has an important role in the management of wheezy infants and in chronic lung disease of prematurity (bronchopulmonary dysplasia).