tiotropium + ipratropium

Tiotropium + ipratropium is a combination of two anticholinergic bronchodilators used in the management of chronic obstructive pulmonary disease (COPD). Both drugs act as antagonists at muscarinic acetylcholine receptors in the airways, leading to relaxation of bronchial smooth muscle and improved airflow. Tiotropium is a long-acting muscarinic antagonist (LAMA) with selectivity for M1 and M3 receptors, providing sustained bronchodilation over 24 hours. Ipratropium is a short-acting muscarinic antagonist (SAMA) that blocks M1, M2, and M3 receptors but has a shorter duration of action. The combination may be considered for patients who require additional bronchodilation beyond monotherapy[1][2][4][5].