inhaled antimuscarinics Flashcards
which ones can be used in asthma, as well as COPD
SAMA: iptratropium
LAMA: tiotropium
how to remember if ipratropium, tiotropium is a SAMA or LAMA
SAMA = short. Ipratropium - I comes first in alphabet so it is a SAMA.
LAMA = long. Tiotropium comes after I in alphabet so it is a LAMA
Name the only SAMA available
ipratropium
is arrhythmias a common SE?
yes
name some common side effects (7)
arrhythmias
constipation
cough
dizziness
dry mouth
headache
nausea
cautions for all inhaled antimuscarinics
bladder outflow obstruction
paradoxical bronchospasm
prostatic hyperplasia
susceptibility to CAG
cautions for glycopyrronium bromide
arrhythmias - not chronic stable AF
Hx MI
Hx QT interval prolong
LV failure
unstable ischaemic heart disease
what type of inhaler does ipratropium come in
pMDI
advice to give if pt taking iptratropium inhaler
pMDI - MHRA advice about risk of airway obstruction from aspiration of loose objects. Always check it is free from anything and always store with mouthpiece on
cautions - using nebulised iptratropium particularly when given with nebulised salbutamol (and possibly other b2 agonists)
acute CAG has been reported
care needed to protect pt eyes from nebulised drug or from drug powder
if a patient is hypersensitive to atropine DO NOT give the following
iptratropium
Tiotropium - Braltus - MHRA safety info
train pt how to use inhaler correctly
store capsules in screw top bottle provided, never the inhaler
this is after repots of pt who have inhaled Braltus capsule from mouthpiece into back of throat, resulting in coughing and risking aspiration or airway obstruction
cautions with tiotropium
arrhythmias (unstable, life threatening or requiring intervention in the prev 12 months)
HF (hospitalisation requires in previous 12 months)
MI in previous 6 months
true or false - a lot of cautions for inhaled antimuscarinics is to do with cardiac issues e.g. MI, unstable arrhtyhmias etc
True
