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The active ingredient in this new inhaler is aclidinium, a long-acting anticholinergic agent that was approved by the FDA for long-term maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD).

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Propofol and remifentanil (an opioid with sedating effects) are the shortest acting sedatives, providing a theoretical advantage if the goal is to titrate sedation to the lowest dose possible.

Cigarette smoke can accelerate the decline in lung function related to asthma.

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This combination of medications has been repeatedly shown in multiple prospective, randomized placebo-controlled trials to improve symptoms, lung function, and quality of life in asthmatics.

One of these patients was withdrawn because metastatic lung cancer was discovered on the day of the randomization visit, and 1 was withdrawn because her private insurance company would not provide health care coverage if she entered a clinical trial.

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National Asthma Education and Prevention Program Expert Panel Report: Guidelines for the Diagnosis and Management of Asthma Update on Selected Topics -- 2002.

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The drug substance, tiotropium bromide monohydrate, is an anticholinergicwith specificity for muscarinic receptors.

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