Notes for: Antimuscarinic BronchodilatorsLast edited [22/08/2013 16:05:02]
1. NICE issued a clinical guideline on COPD in June 2010.
2. A mouthpiece rather than a face-mask should be used when nebulising ipratropium in patients with angle-closure glaucoma as topical ipratropium may worsen glaucoma.
3. MHRA Drug Safety Update (November 2010)
Recent analyses found that Spiriva Respimat was associated with a nonsignificant increase in all-cause mortality compared with placebo. By contrast, Spiriva HandiHaler was associated with a decrease in all-cause mortality compared with placebo. The underlying reasons for the apparent difference are unclear, and may be a chance finding; further studies are ongoing Spiriva Respimat should be used with caution in patients with known cardiac rhythm disorders Patients with COPD who use tiotropium should be reminded not to exceed the recommended once-daily dose of: one Spiriva HandiHaler 18 microgram capsule, or two puffs Spiriva Respimat 2.5 micrograms