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inhaled anticholinergic agent

Includes: - ipratropium inhalation - tiotropium inhalation Adverse effects: - increased cardiovascular risk (1.8 vs 1.2%) - increased risk for arrhythmia in children & young adults [4] - urinary retention, especially in men with BPH [3]

Interactions

drug interactions drug adverse effects of parasympatholytics

Specific

ipratropium (Atrovent) tiotropium (Spiriva, Respimat) umeclidinium (Incruse Ellipta)

General

aerosolized agent bronchodilator parasympatholytic (anticholinergic, antimuscarinic agent)

References

  1. Singh S et al Inhaled Anticholinergics and Risk of Major Adverse Cardiovascular Events in Patients With Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-analysis JAMA 2008;300(12):1439-1450 PMID: 18812535
  2. Prescriber's Letter 15(11): 2008 Safety of Inhaled Anticholinergics for COPD Detail-Document#: 241102 (subscription needed) http://www.prescribersletter.com
  3. Stephenson A et al Inhaled Anticholinergic Drug Therapy and the Risk of Acute Urinary Retention in Chronic Obstructive Pulmonary Disease. Arch Intern Med. 2011;171(10):914-920 PMID: 21606096 http://archinte.ama-assn.org/cgi/content/short/171/10/914 - Singh S, Furberg CD. Inhaled anticholinergics for chronic obstructive pulmonary disease: Comment on "Inhaled Anticholinergic Drug Therapy and the Risk of Acute Urinary Retention in Chronic Obstructive Pulmonary Disease". Arch Intern Med 2011; 171(10):920-922 PMID: 21606097
  4. Journal Watch: Physician's First Watch, May 23, 2012 Massachusetts Medical Society American Thoracic Society Meeting, May 18-23, 2012, San Francisco, CA
  5. Vande Griend JP, Linnebur SA. Inhaled anticholinergic agents and acute urinary retention in men with lower urinary tract symptoms or benign prostatic hyperplasia. Ann Pharmacother. 2012 Sep;46(9):1245-9. Review. PMID: 22851743