New bronchodilators and combinations in COPD treatment

Bronchodilator drugs are widely used therapeutic agents for treatment of asthma and chronic obstructive pulmonary disease (COPD). In order to mantain bronchodilation, both sympathetic system (particularly beta-2 receptors) activation and parasympathetic system inhibition (antimuscarinic effect) mechanisms are utilized. Over 20 years, there were no significant changes in bronchodilator therapy in obstructive pulmonary diseases. In recent years, however, after the development of new ultra long acting bronchodilator drugs, a single dose inhaler treatments per day in the treatment of stable COPD became a current issue. In this review, with the guidence of the current literature, the effects of new beta-2 agonists and anticholinergic bronchodilators will be discussed.