NEW TOOLS IN THE MANAGEMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASES (COPD)
Dr Charlton Collie, MBBS
Diplomate, American Boards of Internal Medicine & Pulmonary

Chronic Obstructive Pulmonary Disease is now one of the leading causes of death worldwide and in the United States of America, it is the fourth leading cause of death. It is primarily a smoker’s disease as cigarette smoking accounts for approximately 80-90% of this illness. The primary intervention in COPD is to encourage smoking cessation.

Since the 1960’s Atropine has been tried in the treatment of bronchospasm because of its anticholinergic effect. However, the widespread use of anticholinergics in COPD was established in the early 1990’s with the development of the first quaternary ion of atropine, ipratropium bromide (Atroven). Subsequently, a more refined quaternary compound called tiotropium (Spiriva) was developed with more specific activity against the M3 muscarinic receptors giving this class of compound increased efficiency and duration in its bronchodilator properties. Lung transplantation and pulmonary rehabilitation programmes are being done now more successfully, as our experience with these techniques improve.