aclidinium

aclidinium

(a-kli-din-ee-um) ,

Tudorza

(trade name)

Classification

Therapeutic: copd agents
Pharmacologic: anticholinergics
Pregnancy Category: C

Indications

Long-term maintenance treatment of bronchospasm associated with COPD, including chronic bronchitis and emphysema.Not for acute (rescue) use.

Action

Acts as an anticholinergic by inhibiting the M3 receptor in bronchial smooth muscle.

Therapeutic effects

Bronchodilation with lessened symptoms of COPD.

Pharmacokinetics

Absorption: 6% systemically absorbed following inhalation.
Distribution: Unknown.
Metabolism and Excretion: Rapidly hydrolyzed; metabolites are not pharmacologically active. Metabolites are eliminated in urine (54–65%) and feces (20–33%). 1% excreted unchanged in urine.
Half-life: 5–8 hr.

Time/action profile (improvement in FEV1)

ROUTEONSETPEAKDURATION
Inhalnwithin 1 hr2–4 hr12 hr

Contraindications/Precautions

Contraindicated in: None noted.
Use Cautiously in: Narrow-angle glaucoma;Prostatic hyperplasia, bladder neck obstruction;Severe hypersensitivity to milk proteins;History of hypersensitivity to atropine (cross-sensitivity may occur); Obstetric: Use during pregnancy only if potential benefit justifies potential risk to the fetus; Lactation: Use cautiously during lactation; Pediatric: Safe and effective use in children has not been established.

Adverse Reactions/Side Effects

Central nervous system

  • headache

Ear, Eye, Nose, Throat

  • worsening of narrow-angle glaucoma

Respiratory

  • paradoxical bronchospasm

Genitourinary

  • urinary retention

Miscellaneous

  • immediate hypersensitivity reactions

Interactions

Drug-Drug interaction

↑ risk of adverse anticholinergic effects with other anticholingerics.

Route/Dosage

Inhalation (Adults) One inhalation (400 mcg) twice daily.

Availability

Dry powder metered-dose inhaler: 400 mcg/actuation

Nursing implications

Nursing assessment

  • Inhalation: Assess respiratory status (rate, breath sounds, degree of dyspnea, pulse) before administration and at peak of medication. Consult health care professional about alternative medication if severe bronchospasm is present; onset of action is too slow for patients in acute distress. If paradoxical bronchospasm (wheezing) occurs, withhold medication and notify health care professional immediately.

Potential Nursing Diagnoses

Ineffective airway clearance (Indications)
Activity intolerance (Indications)

Implementation

  • Inhalation: Administer every 12 hr. See for administration of inhalation medications.
    • When aclidinium is administered concurrently with other inhalation medications, administer adrenergic bronchodilators first, followed by aclidinium, then corticosteroids. Wait 5 min between medications.

Patient/Family Teaching

  • Instruct patient in proper use of inhaler and to take medication as directed. Omit missed doses and take next dose at the usual time; do not double doses. Advise patient to read Medication Guide before beginning therapy and with each Rx refill in case of changes.
  • Advise patient to have a rapid-acting bronchodilator available for use at all times to treat sudden symptoms. Notify health care professional immediately if sudden shortness of breath occurs immediately after using aclidinium inhaler, if breathing becomes worse, if rescue inhaler is needed more often than usual, or if rescue inhaler does not work as well at relieving symptoms.
  • Caution patient to avoid getting powder into eyes.
  • Advise patient to inform health care professional if symptoms of new or worsened increased eye pressure (eye pain or discomfort, nausea or vomiting, blurred visions, seeing halos or bright colors around lights, red eyes), new or worsened urinary retention (difficulty urinating, painful urination, urinating frequently, urination in a weak stream or drips), or allergic reactions (rash, hives, swelling of the face, mouth, and tongue, breathing problems) occur.
  • Advise patient to consult health care professional before taking any Rx, OTC, or herbal products or alcohol concurrently with this therapy. Caution patient also to avoid smoking and other respiratory irritants.
  • Advise patient to notify health care professional if pregnancy is planned or suspected, or if nursing.
  • Explain need for pulmonary function tests prior to and periodically during therapy to determine effectiveness of medication.

Evaluation/Desired Outcomes

  • Decreased dyspnea.
    • Improved breath sounds.
References in periodicals archive ?
Tell your doctor if you take anticholinergics (including umeclidinium, tiotropium, ipratropium, aclidinium, glycopyrrolate), because taking them together with Utibron or Seebri can increase side effects.
AstraZeneca also owns the development rights in the US and Canada for LAS40464, the combination of a fixed dose of aclidinium with formoterol long acting beta agonist (LAMA/LABA) in a dry powder inhaler, which is approved in the EU under the brand name DuaklirA GenuairA.
In conjunction, AstraZeneca will own the development rights in the US and Canada for LAS40464, the combination of a fixed dose of aclidinium with formoterol long acting beta agonist (LAMA/LABA) in a dry powder inhaler, which is approved in the EU under the brand name Duaklir Genuair.
This edition has new drugs, including aclidinium bromide, felbamate, icosapent ethyl, linaclotide, peginesatide acetate, perampanel, rotigotine, and teriflunomide, and updated group monographs for antipsychotic agents, benzodiazepenes, calcium channel blocking agents, estrogens, macrolides, opioid analgesics, proton pump inhibitors, selective serotonin reuptake inhibitors, and serotonin 5-HT1 receptor agonists.
Aclidinium bromide (Tudorza Pressair; bronchodilator) is a respiratory agent used in chronic obstructive pulmonary disease, chronic bronchitis, and emphysema.
Also, some of the newer long-acting antimuscarinic agents (LAMAs) include drugs such as aclidinium and glycopyrrolate.
NYSE:FRX) today announced positive topline results from AUGMENT/COPD, the second six-month pivotal phase III clinical trial evaluating the efficacy and safety of investigational fixed dose combinations of aclidinium bromide (LAMA) and formoterol fumarate (LABA) for the treatment of Chronic Obstructive Pulmonary Disease (COPD), delivered in the Pressair[TM]inhaler (Genuair[sup.
Patients inhale aclidinium through the device, which provides a coloured control window which changes to green to give patients the go-ahead to inhale treatment.
Aclidinium bromide, a long-acting anticholinergic bronchodilator, has been approved as a treatment for chronic obstructive pulmonary disease, for the long-term maintenance treatment of bronchospasm associated with COPD, including chronic bronchitis and emphysema, the FDA announced last month.
The company said the once-daily aclidinium bromide achieved its primary endpoint, showing a statistically significant difference versus placebo in a measure of lung function that is affected in patients with moderate to severe COPD.
AstraZeneca will also own development rights in the US and Canada for LAS40464, the combination of a fixed dose of aclidinium with formoterol long acting beta agonist (LAMA/LABA) in a dry powder inhaler, which is approved in the EU under the brand name DuaklirA Genuair.
When given by inhalation, aclidinium produces bronchodilation by inhibiting the muscarinic M3 receptor in the airway smooth muscle.