Chronic obstructive pulmonary disease tiotropium bromide

Tlotropium bromide (54 Spiriva Boehringer-Ingelheim/Pfizer, 2004) has been approved by the US Eood and Drug Administration (EDA) for the treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD). Tiotropium, a derivative of atropine from Atropa belladonna (Solanaceae), is a potent reversible nonselective inhibitor of... 

Koumis T, Samuel S. (2005) Tiotropium bromide A new long-acting bron-chodilator for the treatment of chronic obstructive pulmonary disease. Clin... 

Prakash O, Kumar R, Rahman M, Gaur SN. (2006) The clinico-physiological effect of inhaled tiotropium bromide and inhaled ipratropium bromide in severe chronic obstructive pulmonary disease. Ind J Allergy Asthma Immunol 20 105-111 For further information http //www.rxlist.com/spiriva-drug.htm (accessed on 24.12.2010). 

Atropine (1) Tiotropium bromide (26) Tropane alkaloid Chronic obstructive pulmonary disease... 

Wedzicha JA, Calverley PM, Seemungal TA, Hagan G, Ansari Z, Stockley RA. INSPIRE Investigators. The prevention of chronic obstructive pulmonary disease exacerbations by salmeterol/fluticasone propionate or tiotropium bromide. Am J Respir Crit Care Med 2008 177(1) 19-26. 

Although epoxides occur less widely in natural products than alcohols or ethers, interesting and useful epoxides are also known. As an example, two recently introduced drugs that contain an epoxide are eplerenone and tiotropium bromide. Eplerenone (trade name Inspra) is prescribed to reduce cardiovascular risk in patients who have already had a heart attack. Tiotropium bromide (trade name Spiriva) is a long-acting bronchodilator used to treat the chronic obstructive pulmonary disease of smokers and those routinely exposed to secondhand smoke. 

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