You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is Non-sympathomimetic Bronchodilator preferred in COPD: and explain in detail?
Ans. (a) Ipratropium bromideRef. Katzung pharmacology 10th ed. Ch 10* Ipratropium bromide is an anti-cholinergic agent/ Muscarinic antagonists which competitively inhibit the effect of acetylcholine at muscarinic receptors.* Ipratropium appears to be at least as effective in patients with COPD that includes a partially reversible component. A longer-acting, selective anti-muscarinic agent, tiotropium, is approved as a treatment for COPD.* Salbutamol and terbutaline are b2 agonist, used in acute cases of asthma.* Salmetrol is slow acting b2 agonist, used for prophylaxis of asthma.