Tiotropium
Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.
Tiotropium (brand name Spiriva) — Bronchodilator; Long-acting anticholinergic (LAMA).
Identification
- Therapeutic class: Bronchodilator.
- Pharmacologic class: Long-acting anticholinergic (LAMA).
Pharmacology
- Mechanism of action: Long-acting muscarinic blockade for sustained bronchodilation.
- Onset / peak / duration: Onset within 30 minutes; duration 24 hours.
- Half-life / therapeutic level: Long; no routine level.
Clinical use
- Indications: COPD maintenance, asthma maintenance (not for acute attacks).
- Usual dose, route, frequency: Inhaled once daily.
- Maximum dose / adjustments: Once daily; caution in renal impairment.
Safety
- Contraindications: Hypersensitivity; caution with narrow-angle glaucoma and urinary retention.
- Black box warning: None.
- Interactions: Other anticholinergics.
- Pregnancy / lactation: Use if needed.
- High-alert: No.
Adverse effects
- Common side effects: Dry mouth, constipation, urinary difficulty.
- Serious effects to report: Acute glaucoma, urinary retention, paradoxical bronchospasm.
- Antidote / reversal: Supportive care.
Nursing process
- Assessment before administration: Glaucoma and prostate history, respiratory status.
- Interventions during therapy: Maintenance only; do not swallow capsules used in the device.
- Monitor: Respiratory status.
- Evaluation / expected outcome: Improved daily breathing.
Patient teaching
- Patient teaching: Use daily for control, not for sudden symptoms; capsules go in the inhaler, not the mouth.
- Notify provider if: Eye pain or vision change, trouble urinating.
- Administration tips: Once daily; correct device technique.