A.I. Sinopalnikov

Russian Medical Academy of Continuous Professional Education, Moscow, Russia
The presented literature review considers the historical aspects of the use of bronchodilators (β2-adrenoagonists and cholinoblockers) in the treatment of chronic obstructive pulmonary disease (COPD). Mechanisms of the action of β2-adrenoagonists and cholinoblockers of various generations, including long-acting drugs (LABAs and LACBs) are discussed; the possibilities of use of long-acting drugs have significantly expanded in recent years. According to GOLD experts’ opinion, fixed-dose combinations of LABAs/LACBs should be considered as first-line drugs for most patients with symptomatic COPD and for almost everyone who needs regular supportive therapy. Great expectations are related to the introduction of triple fixed-dose combinations (LABAs, LACBs and inhaled glucocorticoids) into the practice of COPD pharmacotherapy. Obviously, the accumulation data from real clinical practice in the near and medium term, supplemented by the results of a number of direct comparative studies, will make it easier for the doctor to choose the «right drug» for the «right patient» with COPD.
Keywords: chronic obstructive pulmonary disease, bronchodilators, long-acting β2-adrenoagonists, long-acting cholinoblockers, inhaled glucocorticoids, fixed-dose combinations of drugs

About the Autors

Corresponding author: A.I. Sinopalnikov – MD, Prof., Head of the Department of Pulmonology, Russian Medical Academy of Continuous Professional Education, Moscow, Russia; e-mail:, ORCID:

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