Tiotropium

Tiotropium (Pfizer under the trade name Spiriva.

Mode of delivery

The patient removes from the blister pack one Spiriva capsule and places it into the piercing chamber of the proprietary HandiHaler device and closes the mouthpiece.

The capsule is manually pierced, and the medication is then inhaled through the mouthpiece. It is recommended to be repeat the inhalations, 2 to 3 times, to make sure all medication is drawn from the capsule. When properly done, the capsule will make a distinctive flutter or rattle, to be heard and sensed by the patient.

The manufacturer warns users to only remove the capsule when ready to immediately take. Any advance removal of capsule, or exposing an additional capsule, is to be discarded. This is because any advanced removal will exposed capsule to the air, of which will render the medication ineffective.

Do not take the capsule orally

Mode of action

Tiotropium is a bronchodilatory effect.

Clinical use

Indications

Tiotropium is indicated as a daily, 24 hour, maintenance treatment of chronic obstructive pulmonary disease (COPD).

Adverse effects

Adverse effects are mainly related to its antimuscarinic effects. Common adverse drug reactions (≥1% of patients) associated with tiotropium therapy include: dry mouth and/or throat irritation. Rarely (<0.1% of patients) treatment is associated with: urinary retention, constipation, acute angle closure glaucoma, palpitations, and/or allergy (rash, angioedema, anaphylaxis) (Rossi, 2006).

References

• Rossi S, editor. Australian Medicines Handbook 2006. Adelaide: Australian Medicines Handbook; 2006.

See also

• Chronic obstructive pulmonary disease

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