Tiotropium is a long-acting muscarinic antagonist. Its effect last for 24 hours. It causes relaxation of smooth muscles of the respiratory tract and also helps to decrease the mucus secretion by goblet cells. The chronic obstructive pulmonary disease is characterized by chronic productive cough and shortness of breath. The chronic obstructive pulmonary disease has two components; chronic bronchitis and emphysema. Chronic bronchitis is defined as a productive cough for 3 months for 2 consecutive years. On the other hand, emphysema occurs as a result of the destruction of alveolar walls and air entrapment in the alveoli. The risk factors include cigarette smoking (the most common one), biomass fuel exposure, wood burning smoke, industrial smoke and occupational and chemical exposures, genetics and ageing also have a role in the development and progression of chronic obstructive pulmonary disease (COPD). The noxious stimuli (eg. Cigarette smoke) damages the cilia (hair-like proje
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