Tiotropium
From Wikipedia, the free encyclopedia
 |
|
 |
|
|
Tiotropium
|
|
| Systematic (IUPAC) name | |
| (1α,2β,4β,7β)- 7-[(hydroxidi-2-thienylacetyl)oxy]-9,9-dimethyl- 3-oxa-9-azoniatricyclo[3.3.1.02,4]nonane |
|
| Identifiers | |
| CAS number | |
| ATC code | R03 |
| PubChem | |
| Chemical data | |
| Formula | C19H22NO4S2+ |
| Mol. mass | 490.4 |
| SMILES | & |
| Pharmacokinetic data | |
| Bioavailability | 19.5% (inhalation) |
| Metabolism | hepatic 25% (CYP2D6, CYP3A4) |
| Half life | 5–6 days |
| Excretion | renal |
| Therapeutic considerations | |
| Pregnancy cat. |
B1(AU) |
| Legal status | |
| Routes | inhalation (oral) |
Tiotropium (pronounced /ˌtaɪəˈtroʊpiəm/) (administered as tiotropium bromide) is a long-acting, 24 hour, anticholinergic bronchodilator used in the management of chronic obstructive pulmonary disease (COPD). Tiotropium bromide (INN) capsules for inhalation are co-marketed by Boehringer-Ingelheim and Pfizer under the trade name "Spiriva".
Contents |
[edit] Mode of delivery
The patient removes one tiotropium capsule from the blister pack, places it into the piercing chamber of the inhalation device and closes the mouthpiece.
The capsule is manually pierced, and the medication is inhaled through the mouthpiece. It is recommended that inhalations are repeated 2 to 3 times to ensure all medication is drawn from the capsule. When properly done, the capsule will make a distinctive flutter or rattle, audible to the patient.
Once the powder capsules are removed from the blister pack, it should immediately taken, via through the inhalation device. If a capsule is exposed to the air it will rapidly degrade to the point the dose will become ineffective. Any previously exposed capsules should be discarded.
The capsules cannot be taken orally - they will not be effective as respiratory medication if absorbed through the gastrointestinal tract and may have side effects if absorbed via this route.
[edit] Mode of action
Tiotropium is a muscarinic receptor antagonist, often referred to as an antimuscarinic or anticholinergic agent. Although it does not display selectivity for specific muscarinic receptors, on topical application it acts mainly on M3 muscarinic receptors located in the airways to produce smooth muscle relaxation, thus producing a bronchodilatory effect.
[edit] Clinical use
[edit] Indications
Tiotropium is indicated as a daily, 24 hour, maintenance treatment of chronic obstructive pulmonary disease (COPD).
[edit] 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).
[edit] References
- Rossi S, editor. Australian Medicines Handbook 2006. Adelaide: Australian Medicines Handbook; 2006.
[edit] See also
[edit] External links
[edit] Image collection
 |
|
|
|
||||||||||||||||||||||||||
