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Atrovent is an antimetabolite which interferes with nucleotide synthesis.

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In cas mono-bonchodilatthapy dos not contol symptoms COPD adquatly i gula maintnanc thapy is dsid, a thaputic intvntion with a combination bonchodilatos is commndd. Th isks sid-cts incass with incasing dos any dug and, tho, th most impotant ational combination thapy is a vy avouabl atiicacy and saty. Knowing that anticholingic and bta-adngic agnts achiv thi bonchodilating cts by dint mchanisms, in paticula th combination ths agnts has povn tb bnicial in th managmnt COPD. Basd on th stablishd clinical bnits, tiotopium is an attactiv and pomising agnt th ist-lin long-tm maintnanc thapy in COPD. This alsimplis that a thaputic intvntion with oth bonchodilatos will b pscibd in daily pactic. At psnt nstudis on combination thapy with shot-acting agnts a availabl. Tho, using a doubl-blind, andomisd, cossov dsign, th bonchodilatcts singl doss ipatopium notol w compad with placbwhn addd on top stady stat tiotopium. Patints w p-tatd with tiotopium tachiv this phamacodynamic stady stat. Sial lung unction tsts (V1, VC, aw, sGaw) w conductd ollowing add-on th shot-acting bonchodilatos placbo.

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