This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Asthma, Subject name: Pharmacology
Non-sympathomimetic Bronchodilator preferred in COPD: 
Select and explain. 
A. Ipratropium bromide, B. Salmeterol, C. Terbutaline, D. Salbutamol
A: Ipratropium bromide
Answer: A: Ipratropium bromide 
Explanation: Ans. (a) Ipratropium bromideRef. Katzung pharmacology 10th ed. Ch 10* Ipratropium bromide is an anti-cholinergic agent/ Muscarinic antagonists which competitively inhibit the effect of acetylcholine at muscarinic receptors.* Ipratropium appears to be at least as effective in patients with COPD that includes a partially reversible component. A longer-acting, selective anti-muscarinic agent, tiotropium, is approved as a treatment for COPD.* Salbutamol and terbutaline are b2 agonist, used in acute cases of asthma.* Salmetrol is slow acting b2 agonist, used for prophylaxis of asthma.