Chapman K R
Division of Respiratory Medicine, University of Toronto, Ontario, Canada.
Am J Med. 1991 Oct 21;91(4A):13S-16S. doi: 10.1016/0002-9343(91)90256-w.
Quaternary anticholinergic bronchodilators offer gradual and sustained bronchodilation to patients who have asthma or chronic obstructive pulmonary disease. For asthma, the anticholinergic compounds are less potent than the beta-adrenergic agents but have useful additive bronchodilator properties when combined with beta-adrenergic agents or theophylline. They may be particularly useful in combination regimens for patients who have severe asthma and for older asthmatics. The rationale for such a combination is most compelling in the treatment of acute exacerbations of asthma. For chronic obstructive pulmonary disease, anticholinergic compounds offer greater bronchodilation than beta-adrenergic agents for most patients and are thus considered useful initial therapy in maintenance regimens.
季铵类抗胆碱能支气管扩张剂可为患有哮喘或慢性阻塞性肺疾病的患者提供渐进性且持续性的支气管扩张作用。对于哮喘患者，抗胆碱能化合物的效力低于β-肾上腺素能药物，但与β-肾上腺素能药物或茶碱联合使用时，具有有益的支气管扩张附加特性。它们在重度哮喘患者和老年哮喘患者的联合治疗方案中可能特别有用。这种联合用药的基本原理在哮喘急性加重期的治疗中最为引人注目。对于慢性阻塞性肺疾病，抗胆碱能化合物对大多数患者的支气管扩张作用比β-肾上腺素能药物更强，因此被认为是维持治疗方案中有用的初始治疗药物。
