Anticholinergics

Abstract Anticholinergics block the neurotransmitter acetylcholine in the brain and peripheral tissues. Inhaled anticholinergics, including ipratropium bromide and tiotropium bromide, are important medications in the management of COPD and severe asthma. They have slower onset of action than beta agonists and are therefore used for long-term management rather than acute exacerbations. However, inhaled anticholinergics can be useful in the perioperative setting to mitigate the parasympathetic response to airway instrumentation. This chapter briefly discusses the mechanism of action on anticholinergics and briefly outlines the two major drugs in this class and possible side effects.