Anticholinergics - Tiotropium

Question 1

What is tiotropium used forʔ

Answer 1

• COPD (to relieve breathlessness)

- asthma ( relieve breathlessness during acute exacerbations)

Question 2

ʜow does tiotropium (anticholinergic) workʔ

Answer 2

• competitive inhibitor pf acetylcholine
• reduce smooth muscle tone
• reduce secretions
• relax pupillary constrictor muscles and ciliary muscles —> pupil dilatation + prevent accomodation

Question 3

what are the side effects of tiotropiumʔ

Answer 3

• dry mouth

Question 4

What are the contraindications of tiotropium ( anticholinergic)ʔ

Answer 4

• use in caution with angle-closure glaucoma as can lead to rise in intraocular pressure.
• caution with risk of arrhythmias

***but most pt have no problems

Question 5

What are the drug interactions of tiotropiumʔ

Answer 5

none

Question 6

what is the does of ipratropium (short acting antimuscarinic) for treatment of breathlessness in stable patients.

Answer 6

• 40 mcg , inhaled, four times a day or Pʀɴ

Question 7

What is the dose of ipartropium (short acting antimuscarininc) for the treatment of an acute attack of breathlessnessʔ

Answer 7

250-500 mcg / every 6 hours / nebulised

Question 8

ʜow often are long acting antimuscarinics such as tiotropium prescribedʔ

Answer 8

once daily

18mcg inhaled powder or 5mcg inhaled solution