Tiotropium laba
Common Questions and Answers about Tiotropium laba
spiriva
I take Spiriva Respimat (tiotropium bromide) 2.5 mcg/actuation, and Wixela (fluticasone propionate salmeterol inhalation powder) for my COPD. Is there a sequence I should be taking these meds in? Is there a time frame I should use between the two meds?
Yes, there are. Spiriva® HandiHaler® (tiotropium bromide inhalation powder) is one and Serevent® Inhalation Aerosol (salmeterol xinafoate) another. Each is a bronchodilator and capable of giving good relief of shortness of breath.
Most doctors would start you on a combination medication like Advair, Symbicort or Dulera. These medication have both an inhaled corticosteroid (ICS) and a long acting broncho dilater (LABA). The ICS component can take up to 2 weeks to start feeling it full effect, while the LABA part will be effective immediately to relax and open your airways. Along with that, your doctor should give you directions to use your rescue inhaler (a form of albuterol) regularly for about a week.
The warning is really against the use of long acting beta-2 agonists (LABA - bronchodilaters) alone for the treatment of asthma. Using a LABA without treating the underliing inflamation of asthma is the issue. Since Advair does contain an LABA, it was included in the warning. They are safe when used in combination with inhaled steroids as in Advair and other combination meds.
Alvesco is a small particle ICS that shoulce reduce that problem. I tried it, but it was ineffective for me. I hope it works for you. If you do need a LABA as well, Serevent comes as a stand alone ICS. An LABA should always be used lin combinationwith ICS by asthmatics wheter in a combination med or as two stand alone meds.
I hope that helps you.
God bless.
If from the lungs, you could be experiencing Spiriva® HandiHaler® (tiotropium bromide inhalation powder) withdrawal symptoms, depending on what type of lung problem was being treated with the Spiriva® HandiHaler® (tiotropium bromide inhalation powder). These symptoms, along with your arms feeling weak and heavy, could all be due to anxiety, but could also be symptoms of more serious disease of the heart or lungs. For that reason, you do need to see your doctor to sort this out.
Here is a link to the FDA warning dated February 18, 2010.
http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm200776.htm
The warning is ONLY on the use of LABA medications to treat asthma. LABA's are long acting beta2 agonists (broncho-dilaters that last 12 hours). IT DOES NOT INVOLVE ICS (inhaled corticosteroids) except to say that LABA's should not be used by asthmatics without concurrent treatment with an ICS.
Advair is a combination medication. It has an ihaled corticosteroird (ICS) and a long acting beta2 agonist (LABA - long acting broncho dilater). It is not recommended that you stop taking the ICS all at once. It is a steroid, although it doesn't have the same side effects of oral steroids. The ICS is really the primary treatment for asthma.
After you are feeling better, you can discus trying an ICS only medication like Asmanex or Alvesco with your doctor.
This would include a long-acting bronchodilator, such as Serevent® Inhalation Aerosol (salmeterol xinafoate), Foradil® Aerolizer™ (formoterol fumarate inhalation powder) or Spiriva® HandiHaler® (tiotropium bromide inhalation powder) along with an inhaled steroid. Another potentially helpful, oral medicine is called theophylline. Your doctor may also want to prescribe this.
You should have your blood oxygen level checked, in case it is low and you would need supplemental oxygen.
I have had two physicians tell me that it is due to allergies. I am taking a LABA/ICS and anti-histamine, along with Flonase in the morning. I was also instructed to purchase a HIPA air filter. It has slowed down, however not thing seems to work. I plan to see an ENT to have them check on my Throat.
To manage symptoms and avoid asthma attacks, people with moderate to severe asthma may need a combination inhaler that contains both an inhaled corticosteroid (ICS) and a long-acting beta-agonist (LABA). Kids and the elderly could benefit from different inhaler models. Spacer devices or dry powder inhalers (DPIs) with simpler mechanisms may be more suitable for younger children than conventional metered-dose inhalers (MDIs), which may be difficult for them to use.
Spiriva® HandiHaler® (tiotropium bromide inhalation powder) has a maximum duration of action of about 36 hours. To be safe, you would want to be off the medicine for 48 to 72 hours before the spirometry. It would have been preferable, but not mandatory to do the pulmonary function tests (PFTs) at the time the diagnosis of chronic lung disease was made especially if the diagnosis was unequivocal. The other important question would be, “Why 3 CT scans, presumably of your lungs, in 16 months?
Cause of low DLCO and drop in it from test 1 to test 1? I am currently on tiotropium bromide and salmeterol/fluticasone propionate. My reason for posting this is one doc is pessimistic and the other highly optimistic.
Thank you.
Spiriva contains tiotropium bromide which is an anticholinergic bronchodilator. So, yes, both have action against acetylcholine recptors and both are efefctive bronchodilators. You can take any one of them.
Indacaterol is an ultra-long-acting beta-adrenoceptor agonist. So, it gives bronchodialation for a much longer time. It is a more recent drug so long term efficacy data are not available. However, available data does show a marked benefit in individuals with COPD.
Was changed by my doctor from advair 500/50 twice a day to flovent 220 two puffs twice a day as he believed the LABA in advair was making asthma worse. He was right and feel better. Even when I haven't been on flovent/advair my peak flow has been totally normal as well as all parts of the pulmonary function test. My only main asthma symptom is tight chest hard to take a good deep breath inward. I've never had a challenge test or anything like that. The asthma popped up around age 21.
It has two active components a cortocosteroid (antiinflamatory) AND an LABA (long acting beta2 agonist that lasts 12 hours). Beta2 agonists are the broncho-dilaters. There are two kinds - long and short acting. Long acting forms are not recommend for use by asthmatics unless they are also being used with a corticosteroid as in Advair (Symbicort and Dulera as well). Short acting forms are a form of albuterol. They last about four hours and are considered the rescue inhaler.
Both are combination medications with an inhaled steroid (ICS) and a long acting beta2 agonist (LABA - broncho dilaters). It is not good to take these two medication together as you are double dosing them.
Do you also have a rescue medication? Some for of albuterol - ProAir, Proventil, Maxair, Ventolin, Xopenex and a few others. This is a necessity for when you have the shortness of breath (sob) feeling.
Did the hospital tell you what to do about your potassium level?
t always correspond, sometimes PEF can show weak with even a normal FEV1. The doctor gave me combination drug with 250/50 steroid/LABA. The chest sound produced no wheezing. Remember he didn't do a PFT, just a Peak flow test. I thought he was wrong because my chest was not obstructed, but restricted.. in other words I have trouble getting the air in. I had low reserve volume and my obesity(increasing because I'm unable to exercise) may be playing a role in it.
If you do just have a rescue inhaler, you probably need an inhaled corticosteroid (ICS) and possibly a long acting beta2 agonist (LABA - long acting broncho dilater (similar to a rescue inhaler only they last 12 hours)). LABA's should only be used in conjunction with an ICS by asthmatics (COPD patients can use them alone).
I hope that helps you some. Please keep us posted and let us know how we can be of more help.
It is kind of complex. Salmeterol and albuterol are in the same class of medicines - beta2 agonists (simply put - broncho dilaters). Salmeterol is a long acting beta2 agonist (LABA) and albuterol is a short acting beta2 agonist. LABA's take longer to work and last 12 hours. The short acting ones should work in about 5 - 10 minutes maximum and only lasts 3 - 4 hours.
About the air freshners - I am very reactive to any odor, even foods. Air freshners are worse than most things.
Hello again. Serevent is a long acting beta2 agonist (LABA) or long acting broncho dilater in laymen's terms. All LABAs are not recommend for asthmatics unless they are using an inhaled corticosteroid - I assume that is what the cortisone is. You might want to talk to your dr about a combination med like Symbicort, Advair or the new Dulera. The other issue with LABAs is that people try to use them as rescue inhalers.
A last choice and one that they try to keep at minimum usage are long acting broncho dilaters (long acting beta2 agonists - LABA). These medications are in the combination meds Advair, Symbicort and Dulera and can be prescribed as single medications as well (Severvent, Foradil and a few others). There is a FDA warning that came out about a year ago advising against the long term use of these medications in the treatment of asthmatics.
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