Typically, LAMAs like Tiotropium operate by inhibiting the workspaces of muscarinic receptors on the airway's smooth muscles. Therefore, this activity is counteractive for bronchoconstriction and also alters the airways to make it easier for COPD patients to breathe and better their circulation(Bollmeier & Hartmann, 2020). At the same time, ICS like fluticasone reduces the inflammation of airways. This is achieved by inhibiting the release of inflammatory mediators and cytokines while suppressing the immune responsev
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