Nurses Compass
Drug Guide
Umeclidinium Bromide
Classification
Therapeutic: Bronchodilator for COPD
Pharmacological: Long-acting muscarinic antagonist (LAMA)
FDA Approved Indications
- Long-term maintenance treatment of airflow obstruction in patients with COPD, including chronic bronchitis and emphysema.
Mechanism of Action
Umeclidinium bromide is a long-acting muscarinic antagonist that blocks the M3 muscarinic receptors in airway smooth muscle, leading to bronchodilation.
Dosage and Administration
Adult: One inhalation (62.5 mcg) once daily via the inhaler.
Pediatric: Not indicated for pediatric use.
Geriatric: No specific dosage adjustment; monitor for anticholinergic side effects.
Renal Impairment: Use with caution; no specific dosage adjustments established.
Hepatic Impairment: Use with caution; no specific dosage adjustments established.
Pharmacokinetics
Absorption: Rapid absorption after inhalation.
Distribution: Widely distributed in body tissues.
Metabolism: Primarily excreted unchanged; minimal metabolism.
Excretion: Excreted mainly via feces and urine.
Half Life: Approximately 11 hours.
Contraindications
- Hypersensitivity to umeclidinium bromide or other anticholinergic drugs.
Precautions
- Use with caution in patients with hypersensitivity to atropine or related compounds. May cause anticholinergic effects such as dry mouth, constipation, urinary retention, and blurred vision. Not recommended for use in patients with narrow-angle glaucoma.
Adverse Reactions - Common
- Dry mouth (Common)
- Cough (Common)
- Headache (Less common)
Adverse Reactions - Serious
- Paradoxical bronchospasm (Uncommon)
- Eyes irritation or blurred vision due to contact with the eyes (Uncommon)
Drug-Drug Interactions
- Other anticholinergic drugs (additive effects)
- Potassium chloride orally or IV (may cause increased GI or urinary retention)
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor respiratory status, lung function tests, and for anticholinergic effects.
Diagnoses:
- Impaired airways clearance related to bronchodilation therapy.
- Risk for anticholinergic side effects.
Implementation: Administer via inhaler as prescribed. Educate patient on proper inhaler technique.
Evaluation: Assess respiratory function and symptom relief periodically, monitor for adverse effects.
Patient/Family Teaching
- Use inhaler regularly, even when symptoms improve.
- Report signs of paradoxical bronchospasm or allergy.
- Avoid contact with eyes.
- Report anticholinergic side effects such as dry mouth.
Special Considerations
Black Box Warnings:
- None reported for Incruse Ellipta.
Genetic Factors: No known genetic considerations affecting drug efficacy.
Lab Test Interference: No known interference with laboratory tests.
Overdose Management
Signs/Symptoms: Severe anticholinergic effects: dry mouth, urinary retention, blurred vision, tachycardia, hallucinations.
Treatment: Supportive care; activated charcoal if ingestion recent; symptomatic treatment and observation.
Storage and Handling
Storage: Store at room temperature, away from moisture and heat.
Stability: Stable until expiration date on the package.