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Tiotropium (Spiriva) 💊
Always check the BNF link here for up-to-date prescribing advice.
- 💨 Long-acting bronchodilator, mainly used in COPD.
- Anticholinergics (LAMA – long-acting muscarinic antagonists) are first-line bronchodilators in COPD maintenance.
⚙️ Mechanism of Action
- Blocks muscarinic M3 receptors on airway smooth muscle → sustained bronchodilation.
- Onset: 30–60 minutes ⏱️.
- Duration: up to 24 hours → once-daily dosing.
- More effective in COPD than asthma (though sometimes used as add-on in severe asthma).
🎯 Indications
- Once-daily maintenance therapy in COPD (improves symptoms, exercise tolerance, reduces exacerbations).
- Not suitable for acute bronchospasm 🚫 (slower onset than SABAs like salbutamol).
💊 Dose
- Administered by inhalation (metered-dose inhaler, dry-powder inhaler, or Respimat device).
- COPD maintenance: Tiotropium 18 mcg OD inhaled (onset 30–60 min, duration 24 h).
⚠️ Cautions & Contraindications
- Glaucoma (risk of precipitating angle-closure if drug enters eye).
- Cardiac conditions: CCF, arrhythmias ❤️.
- Prostatic hypertrophy / urinary retention issues 💧.
⚠️ Side Effects
- Dry mouth, blurred vision 👁️, constipation.
- Urinary retention (especially in men with BPH).
- Dilated pupil / acute angle-closure glaucoma if inhaled drug gets into eyes.
- Paradoxical bronchospasm (rare but serious).
- Allergic reactions (rash, angioedema, urticaria).
📚 References
- BNF – Tiotropium
- GOLD COPD Guidelines.
- Oxford Handbook of Clinical Medicine.
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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