Which anticholinergic is indicated for asthma and COPD and is often combined with a beta-adrenergic agonist?

• A. Ipratropium
• B. Tiotropium
• C. Glycopyrrolate
• D. Aclidinium

Answer: (A)

Anticholinergic bronchodilators work by blocking acetylcholine on muscarinic receptors in the airways, which decreases vagal-induced bronchoconstriction and reduces mucus secretion. This makes the airways wider and easier to breathe, especially when inhaled directly into the lungs.

The best answer is ipratropium because it is a short-acting anticholinergic indicated for both asthma and COPD and is routinely used in combination with a beta-adrenergic agonist. In asthma, it’s commonly added to a beta-agonist like albuterol during acute exacerbations to enhance bronchodilation. In COPD, it’s used alongside beta-agonists for additional relief of airflow obstruction. The other agents are either long-acting and primarily used for COPD maintenance (tiotropium and aclidinium) or are less typical for asthma management (glycopyrrolate).