Muscarinic receptor antagonists

A compound of the formula:

• wherein
• Lb is a group of formula (i) or (j):
• wherein:
• R46 is alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, or heterocycle;
• R47 is alkyl, substituted alkyl, aryl, acyl, heterocycle, or —COOR49 where R49 is alkyl;
• or R46 and R47 together with the nitrogen atom to which they are attached form a heterocycle;
• R48 is a covalent bond that attaches (i) or (j) to X;
• R49 is alkyl;
• and
• X is a group of the formula:
• —Xa-Z-(Ya-Z)m-Yb-Z-Xa—
• wherein
• m is 1;
• xa at each separate occurrence is a covalent bond;
• Z at the first and third occurrence is alkylene;
• Z at the second occurrence is selected from the group consisting of alkylene, substituted alkylene, alkenylene, substituted alkenylene, alkynylene, and substituted alicynylene;
• Ya and Yb at each separate occurrence are selected from the group consisting of a covalent bond, —O—, —C(O)—, —OC(O)—, —C(O)O—, —NR—, —S(O)n—, —C(O)NR′—, —NR′C(O)—, —NR′C(O)NR′—, —NR′C(S)NR′—, —C(=NR′)NR′—, —NR′C(=NR′)—, —OC(O)NR′—, —NR′C(O)O—, —P(O)(OR′)O—, —OP(O)(OR′)—, —S(O)nCR′R″—, —S(O)nNR′—, —NR′S(O)n—and —S—S—;
• n is 0, 1 or 2;
• and
• R, R′ and R″ at each separate occurrence are selected from the group consisting of hydrogen, alkyl, substituted alkyl, cycloalkyl, substituted cycloalkyl, alkenyl, substituted alkenyl, cycloalkenyl, substituted cycloalkenyl, alkynyl, substituted alkynyl, aryl, heteroaryl and heterocyclic;
• or a pharmaceutically-acceptable salt thereof.