To give a quick review of the introduction and development of anticholinergic medications in Western medicine, as well as their contemporary indications, notably in asthma. Although short-acting muscarinic antagonists have been positioned in the last 15 years for the emergency treatment of adults and children with moderate-to-severe acute asthma (reducing the risk of hospital admissions and improving lung function), a growing body of evidence has recently emerged that positions the long-acting muscarinic anticholinergic tiotropium bromide as an add-on therapy. Thus, adding tiotropium bromide to ICS alone or ICS plus another controller resulted in significant improvements in spirometric measurements and asthma control, as well as a significant decrease in the occurrence of asthma exacerbations.

Short-acting muscarinic antagonists and tiotropium bromide have long been used to treat various stages of asthma. More evidence is needed to support the use of additional selective long-acting muscarinic antagonists, in addition to tiotropium, as viable therapeutic alternatives.