Tiotropium monograph
Common Questions and Answers about Tiotropium monograph
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.
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.
Anyone here know anything about zetia and its affect on the thyroid and or levo absorption? I have read it may affect absorption and the rx monograph says talk tp your doctor if you have thyroid disorders.
He knows I am on synthroid, but I am curious how this drug affects it.
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.
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.
When the Institute of Medicine brought forth its monograph on the development of trustworthy practice guidelines, it pointed to the IDSA Lyme Disease guidelines as an example of a guideline development process ‘gone awry’.
//www.clevelandclinicmeded.com/online/monograph/hepc/cirrhosis.htm
Here is a link to a 39 minute video presentation given by one of my doctors, Norah Terrault, to other doctors at UCSF on March 6, 2008. (Dr. Terrault directs the Hep C treatment programs at University of California San Francisco). This presentation gives the lastest info on HCV and cirrhosis.
“Management of Hepatitis C in the Pre-Transplant Patient with cirrhosis (compensated and decompensated)”
http://www.uctv.
Looked at the drug interactions monograph, thought it was a reaction to the generic Zyrtec and called my doc. He told me to stop taking the zyrtec and ordered liver function tests. Well, tests came back with high enzymes and bilirubin and he told me to stop taking ALL medications. Ordered an ultrasound which he said was negative, and ordered the blood work again. He seems to think it's liver damage due to drug toxicity.
I have been doing lots of reading on the internet, and also, of the monograph provided with the medicine. I am reading about side effects such as dizziness, shortness of breath, all kinds of awful things. I have dizziness due to vertigo (believed by my Dr. to be due to fluid in ears / virus), and wonder how I'll be able to tell whether any diziness is a side effect or the vertigo. It's all very new and confusing to me.
http://en.wikipedia.org/wiki/Primary_sclerosing_cholangitis
Most patients with PSC (80%) also have ulcerative colitis.
I have to question the appropriateness of a liver biopsy if PSC is the suspected disease. From what I know and according to the sources I have a biopsy isn't usually determinative of PSC. Imaging studies are usually done first.
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