Home Drug Guide Revefenacin

Drug Guide

Generic Name

Revefenacin

Brand Names Yupelri

Classification

Therapeutic: Respiratory agent

Pharmacological: Long-acting muscarinic antagonist (LAMA)

FDA Approved Indications

  • Chronic obstructive pulmonary disease (COPD)

Mechanism of Action

Revefenacin is a long-acting muscarinic antagonist that blocks M3 muscarinic receptors in airway smooth muscle, leading to bronchodilation.

Dosage and Administration

Adult: 1 vial (175 mcg) inhaled once daily via nebulizer.

Pediatric: Not indicated for pediatric use.

Geriatric: No specific dosage adjustment required, but caution in elderly due to potential for increased sensitivity.

Renal Impairment: No specific adjustment required; use with caution.

Hepatic Impairment: Limited data; use with caution.

Pharmacokinetics

Absorption: Absorbed via inhalation, systemic absorption is minimal.

Distribution: Extensive distribution in lung tissue; plasma protein binding approximately 40%.

Metabolism: Extensively metabolized by CYP2D6 and CYP3A4 enzymes.

Excretion: Primarily excreted in feces, minimal urinary excretion.

Half Life: Approximately 52 hours.

Contraindications

  • Hypersensitivity to revefenacin or any component of the formulation.

Precautions

  • Use with caution in patients with narrow-angle glaucoma, urinary retention, or bladder neck obstruction.

Adverse Reactions - Common

  • Dry mouth (Common)
  • Cough (Common)

Adverse Reactions - Serious

  • Urinary retention (Rare)
  • Allergic reactions including rash, urticaria (Rare)

Drug-Drug Interactions

  • Other anticholinergic agents may increase anticholinergic side effects.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor lung function, assess for anticholinergic side effects, and evaluate for urinary retention.

Diagnoses:

  • Ineffective airway clearance
  • Potential for urinary retention

Implementation: Instruct patient on correct inhalation technique, monitor for side effects.

Evaluation: Assess improvement in breathing and monitor for adverse reactions.

Patient/Family Teaching

  • Use inhaler daily as prescribed.
  • Report any signs of dry mouth, urinary problems, or allergic reactions.
  • Do not stop medication abruptly.
  • Maintain regular follow-up appointments.

Special Considerations

Black Box Warnings:

  • None specific for revefenacin.

Genetic Factors: CYP2D6 poor metabolizers may have altered drug levels.

Lab Test Interference: No known interference.

Overdose Management

Signs/Symptoms: Severe anticholinergic effects such as hallucinations, agitation, urinary retention, tachycardia.

Treatment: Supportive care, activated charcoal if recent ingestion, and symptomatic treatment. No specific antidote.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F); avoid moisture and direct sunlight.

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.