Bronchodilator in COPD

Ans. is 'a' i.e., Anticholinergics Anticholinergic bronchodilators Anticholinergic acts on receptors located mainly in the larger central airways (Contrast sympathomimetics whose primary site of action is peripheral bronchioles). Parasympathetic tone is the major reversible factor in COPD. Anticholinergics are more effective than sympathomimetics. Ipratropium and tiotropium are anticholinergic bronchodilators. Tiotropium is longer acting than ipratropium. Inhaled ipratropium / tiotropium are bronchodilators of choice in COPD.