Chronic obstructive pulmonary disease (COPD) is the name for a group of chronic lung conditions that cause breathing problems. COPD includes emphysema and chronic bronchitis. Long-acting muscarinic receptor antagonists (LAMA) are a treatment option for people with COPD.

A person with COPD may have emphysema, chronic bronchitis, or both.

Emphysema involves the gradual damage of lung tissues, specifically the tiny air sacs in the lungs, called alveoli.

Over time, emphysema causes the air sacs to rupture, which reduces the surface area of the lungs, trapping air in the damaged tissues. This can cause the lungs to slowly overfill and may lead to a person experiencing difficulty breathing.

Chronic bronchitis occurs when the airways in a person’s lungs become inflamed. Unlike acute bronchitis, chronic bronchitis is a lifelong condition with no known cure.

Chronic bronchitis can cause a person to experience coughing spells, wheezing, chest pain, and shortness of breath.

LAMA drugs are a treatment option for people with COPD.

This article will examine what LAMA are, how they work for COPD, and common LAMA medications.

It will also look at the side effects, how to take the medications, and how they compare to another COPD treatment option called long-acting beta-agonists (LABA).

A woman taking LAMA medication for COPD.Share on Pinterest
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LAMA are drugs that people can use to treat the symptoms of COPD. A person takes these drugs using a bronchodilator inhaler.

If a person is experiencing wheezing and shortness of breath, the muscles in their lungs that surround the airways, called bronchi and bronchioles, may be tightening.

LAMA prevent these muscles from tightening, helping people breathe more easily.

Doctors call these drugs “long acting” because their effects can last for a prolonged period of time.

The bronchi and bronchioles are airways in the lungs. People with COPD can sometimes experience bronchoconstriction.

This occurs when the smooth muscle around these airways constricts. This tightens the airways and causes the clinical symptoms of COPD, which include:

  • wheezing
  • chest tightness
  • shortness of breath

Many things can cause bronchoconstriction, such as exposure to chemicals, gases, particles, and biological agents. Sudden temperature changes may also lead to bronchoconstriction.

These factors can trigger neural signals. These signals cause the constriction of the muscles that surround the airways.

Acetylcholine is a neurotransmitter that plays a role in bronchoconstriction. Neurotransmitters are the body’s chemical messengers that transmit neural signals around the body.

LAMA medications work by blocking the bronchoconstriction effect of acetylcholine. This prevents the neurotransmitter from causing the muscles surrounding the lungs’ airways to constrict, reducing symptoms of COPD.

These drugs are also long-acting. This means that people often only need to take them once or twice a day.

Common LAMA medications include:

Tiotropium (TIO)

Tiotropium (TIO) bromide was the first LAMA medication available for COPD in clinical practice.

A 2015 article states that it is an effective treatment option for people with moderate to severe COPD.

The authors suggest that TIO can prolong the time between symptoms and reduce the frequency of symptoms. It can also reduce the frequency of hospitalizations associated with COPD.

Some scientists believe that TIO has a possible anti-inflammatory mechanism that may help combat COPD. However, more research is required to determine this.

TIO has a long duration of action, meaning that people with COPD take this medication once daily.

Umeclidinium (UMEC)

Umeclidinium (UMEC) is a LAMA medication that people with COPD take once daily.

Studies have shown that UMEC can cause people with COPD to experience improvements in lung function, health-related quality of life, and the frequency of COPD symptoms.

People take UMEC using a dry powder inhaler. Research shows that UMEC provides adequate lung delivery in people with moderate to severe airflow obstruction.

UMEC is a safe and effective treatment for the management of COPD.

Glycopyrronium (GLY)

Glycopyrronium (GLY) is another LAMA medication that people with COPD take once daily.

GLY is a fast-acting treatment that is effective for people with moderate to severe COPD.

A 2018 article notes that GLY improves lung function, reduces a person’s risk of developing symptoms, and lessens the symptoms of breathlessness.

People tolerate GLY well, and studies have reported few cardiovascular-related side effects associated with GLY treatment. GLY has a similar safety profile to TIO.

Aclidinium (ACL)

Aclidinium (ACL) is a LAMA medication that people with COPD take twice daily.

ACL can reduce symptoms of COPD and has a similar effect and safety profile to TIO for the treatment of stable COPD.

Studies show that the twice-daily administration of ACL provides better lung function in the second 12 hours of the day.

Generally, people tolerate LAMA medications well, and they have good safety profiles.

Side effects can include dry mouth, urinary retention, and constipation.

If a person gets LAMA medication in their eye, then they may experience blurred vision, and it can increase their chances of developing glaucoma.

A person takes LAMA medication with the use of a bronchodilator inhaler. These inhalers use a variety of medications that smooth out the muscle in the lungs’ airways.

People use a bronchodilator inhaler by taking the following steps:

  1. Shake the inhaler before use.
  2. Remove the cap from the mouthpiece.
  3. Breathe in and then breathe out completely.
  4. Put the mouthpiece in the mouth and point the canister upward.
  5. Take a fast, deep breath through the mouth while pressing the button on the canister.
  6. The person should then hold their breath for a few seconds so the LAMA medication is dispersed around their lungs.
  7. Remove the mouthpiece from the mouth and breathe normally.
  8. Replace the cap on the mouthpiece after each use.
  9. After using the inhaler, a person should rinse their mouth out with water.

Another treatment option for COPD are long-acting beta-agonists (LABA). LABA relax the airways’ smooth muscle to prevent bronchoconstriction.

Research shows that LAMA may be a more effective treatment for COPD than LABA.

One review of 19 randomized control trials revealed that treatment with LAMA in stable COPD provided a significant decrease of symptoms and nonserious adverse events when compared to treatment with LABA.

A 2019 review looked at LAMA and LABA combination treatments. This involves people with COPD using an inhaler that contains a combination of both LAMA and LABA.

The review concluded that LAMA and LABA combinations are an effective treatment for people with COPD who have persistent symptoms.

The two medications combined have a synergistic effect and can improve lung function, lung hyperinflation, exercise tolerance, the frequency of COPD exacerbations, and quality of life.

If a person is experiencing particularly bad symptoms of COPD, they should contact a doctor.

A person should contact a doctor right away if they experience trouble breathing or signs of a lung infection such as pneumonia.

If a person has COPD and experiences the following symptoms, they should seek immediate medical attention:

  • chest pains
  • rapid breathing
  • rapid heart rate
  • blue or grey lips or nails
  • a high fever with other flu-like symptoms, such as chills or shaking
  • confusion
  • slurred speech

COPD is the name for a pair of chronic lung conditions that cause breathing problems. These conditions are emphysema and chronic bronchitis.

Common symptoms of COPD include coughing spells, wheezing, chest pain, and shortness of breath.

LAMA are an effective treatment option for people with COPD.

These drugs block the bronchoconstriction effect of acetylcholine. This prevents acetylcholine from causing the muscles surrounding the lungs’ airways to constrict. This reduces the symptoms of COPD.

A person takes LAMA using a bronchodilator inhaler. TIO, UMEC, and GLY are LAMA medications that people take once a day. ACL is a LAMA medication that people take twice a day.