Name: LAMA (long acting muscarinic agonist) Tiotropium, umeclidinium, glycopyrrolate "TUG" (the man is tugging on the lead), all end in -IUM (on the llama's "shirt?" idk what you call that) MOA: Antagonist of muscarinic receptors in the lungs. (stepping on mushrooms). ACh action at these receptors causes vasoconstriction. Thus, antagonism here allows bronchodilation. Use: Initial therapy for COPD. Improvement in FEV1, QOL and dyspnea, reduced number of exacerbations in COPD and asthma, decreased hospitalizations in COPD. Adverse Effects: Dry mouth (the desert), sinusitis (the pink in the head), pharyngitis (the red tie at the throat), URI (there are boogers coming out the llamas nose if you can see it)

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