Bronchodilators - Antimuscarinics (LAMA)

Antimuscarinics are predominantly used in the management of COPD and occasionally used to treat asthma. Antimuscarinics cause the airways to relax by blocking nerve impulses which tell the smooth muscles in the airways to contract. 

Another effect of LAMAs (long-acting muscarinic antagonists) is that they can reduce the amount of mucus produced. They can be used as additional management for chronic symptoms. The duration of effect of available LAMAs varies considerably.

Drug names:

  • Ipratropium – inhaler and can be nebulised (3-6 hours).
  • Glycopyrronium – (24hours).
  • Aclidinium – (12 hours).
  • Tiotropium – (24 hours).
  • Umeclidinium – (24 hours).

The action of LAMAs has maximal effect 30-60 minutes after use, they have no immediate effect. They are used with other inhaled medications.

Side effects:

  • Dry mouth – a commonly reported side effect from antimuscarinics. This can be minimised in   some case by changing the type of inhaler device.
  • Headaches can also be common.
  • Urinary retention-  caution should be used in older men who have prostate problems.