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Tiotropium bromide, originally marketed as Spiriva, is a long-acting, 24-hour, anticholinergic bronchodilator used in the management of chronic obstructive pulmonary disease (COPD).
Tiotroprium was discovered in 1991 by Boehringer Ingelheim and came to market in 2004.
1 Medical uses
2 Adverse effects
3 Mechanism of action
5 External links
Tiotropium is used for maintenance treatment of chronic obstructive pulmonary disease (COPD) which includes chronic bronchitis and emphysema.
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 (notably supraventricular tachycardia and atrial fibrillation ) and/or allergy (rash, angioedema, anaphylaxis ).
Tiotropium and another member of its class ipratropium were linked to increased risk of heart attacks, stroke and cardiovascular death.
Tiotropium mist inhaler ( Respimat ) has been found to be associated with an increase of all cause mortality in people with COPD.
Mechanism 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, when topically applied it acts mainly on M 3 muscarinic receptors located on smooth muscle cells and submucosal glands. This leads to a reduction in smooth muscle contraction and mucus secretion and thus produces a bronchodilatory effect.
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