it has an onset of 15 minutes, peak effect within 1 to 2 hours and a duration of 2 to 5 hours, while long acting (LAMAs) tiotropium bromide, aclidinium bromide, and umeclidinium bromide have action duration of 24 hours or more (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). These medications also work by relaxing airway smooth muscle and increasing bronchial ciliary
activity. Adverse effects are dry mouth, cough when inhaled and blurred vision when it gets in the eyes. Corticosteroids: Short course oral corticosteroids like prednisone is used for acute COPD exacerbation while inhaled corticosteroids are used in combination with long acting bronchodilators to reduce the risk of exacerbations (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). Adverse effects of inhaled corticosteroids include oral candidiasis and dysphonia; therefore, patients should be educated to rinse their mouth, gargle, and spit out the water after each dose (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). Age (Geriatrics) as a factor In most cases, older persons are more prone to cardiovascular diseases; therefore, they may be at risk from cardiovascular stimulatory effects of beta 2 adrenergic agonists especially with higher doses (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). In older adults as well, the theophylline clearance may be decreased, thus resulting to increased risk of theophylline cardiovascular stimulatory adverse effects. The blood theophylline needs to be monitored closely (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). Older adult in most cases take multiple drugs, therefore, drug to drug interaction is a possibility. Higher doses of inhaled corticosteroids can
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- Summer '15
- Chronic obstructive pulmonary disease, Arcangelo, chronic bronchitis, Wilbur, Reinhold