Tiotropium: a new, long-acting agent for the management of COPD--a clinical review.

Tiotropium is a major advance in the management of COPD. Clinical trials have shown that this product administered once a day improves overall lung function, reduces dyspnea, improves quality of life, and reduces hospitalizations. It does have the common adverse effect of an increase in dry mouth. The once-a-day dosing and easy-to-use HandiHaler device should improve patient compliance. Overall, based on the product profile, tiotropium appears to be an effective first-line agent in the management of COPD in the nursing home.