Home Drug Guide Aclidinium Bromide

Drug Guide

Generic Name

Aclidinium Bromide

Brand Names Tudorza Pressair

Classification

Therapeutic: Bronchodilator for COPD

Pharmacological: Long-acting anticholinergic (antimuscarinic) agent

FDA Approved Indications

  • Maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD) including chronic bronchitis and emphysema

Mechanism of Action

Aclidinium bromide selectively antagonizes M3 muscarinic receptors in airway smooth muscle, leading to inhibition of parasympathetic bronchoconstriction and resulting in bronchodilation.

Dosage and Administration

Adult: Use one inhalation (400 mcg) twice daily at approximately 12-hour intervals.

Pediatric: Not indicated for pediatric use.

Geriatric: No specific dosage adjustment; monitor for anticholinergic side effects.

Renal Impairment: No specific adjustment recommended.

Hepatic Impairment: No specific adjustment recommended.

Pharmacokinetics

Absorption: Rapidly absorbed with peak plasma levels in approximately 5 minutes.

Distribution: Widely distributed; high plasma protein binding.

Metabolism: Hydrolyzed quickly by esterases; minimal CYP450 involvement.

Excretion: Primarily via urine as inactive metabolites; minor via feces.

Half Life: Approximately 12 hours.

Contraindications

  • Hypersensitivity to aclidinium bromide or quaternary ammonium compounds.

Precautions

  • Use with caution in patients with urinary retention, glaucoma, or prostate enlargement due to anticholinergic effects.
  • Not a rescue inhaler; not for acute bronchospasm.

Adverse Reactions - Common

  • Headache (Common)
  • Sore throat, cough (Common)
  • Nasopharyngitis (Common)

Adverse Reactions - Serious

  • Acute bronchospasm (Rare)
  • Paradoxical bronchospasm (Rare)
  • Ulcers or throat irritation (Rare)

Drug-Drug Interactions

  • Other anticholinergic agents; increased anticholinergic side effects.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor respiratory status and lung function; assess for anticholinergic side effects.

Diagnoses:

  • Impaired gas exchange
  • Ineffective airway clearance

Implementation: Administer via Diskus inhaler as prescribed; educate patient on proper inhaler technique.

Evaluation: Assess improvement in respiratory symptoms and lung function tests.

Patient/Family Teaching

  • Instruct on correct inhaler use and cleaning.
  • Advise to report any signs of paradoxical bronchospasm, such as worsening breathing or wheezing.
  • Counsel about common side effects like dry mouth and thirst.

Special Considerations

Black Box Warnings:

  • None currently

Genetic Factors: None specified.

Lab Test Interference: None known.

Overdose Management

Signs/Symptoms: Severe anticholinergic effects such as dry mouth, blurred vision, urinary retention, tachycardia, hallucinations.

Treatment: Supportive care, activated charcoal if recent ingestion, and symptomatic management. No specific antagonist.

Storage and Handling

Storage: Store at room temperature below 30°C (86°F); keep inhaler dry.

Stability: Stable until the expiration date printed on the packaging.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.