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Updated: Dec 29 2021

Inhaled Muscarinic-Antagonists

  • Snapshot
    • A 12-year-old boy is brought to the emergency department for difficulty breathing and wheezing. Per the mother, the patient has a history of asthma and has been stable with his rescue inhaler. However, he began coughing 3 days ago and his breathing has gotten progressively worse. A physical examination demonstrates subcostal retractions and diffuse wheezing throughout the lung fields.
  • Overview
    • One of 7 medications used for asthma aimed to reduce inflammation and obstruction 
      • Corticosteroids
      • β-agonists 
      • Muscarinic antagonists 
      • Methylxanthines
      • Cromolyn
      • Antileukotrienes 
      • Omalizumab 
  • Inhaled Muscarinic Antagonists
    • Mechanism of action
      • competitive blockade of muscarinic receptors which allows for bronchodilation
        • examples
          • tiotropium and ipratropium
        • tiotropium is long-acting
    • Clinical use
      • asthma exacerbation
        • often used in combination with short-acting β-adrenergic agonist  
      • chronic obstructive pulmonary disease (COPD) 
    • Adverse effects
      • paradoxical
      • bronchospasm
      • angle-closure glaucoma
      • bronchitis
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    QID 105857 (Type "105857" in App Search)
    A 60-year-old man presents to the emergency department complaining of worsening exertional dyspnea over the last week. He denies chest pain and lightheadedness but reports persistent cough with white sputum. His past medical history includes hypertension and diabetes mellitus. He has a 50 pack-year history of smoking but denies any illicit drug use or alcohol consumption. His temperature is 101°F (3...
    Pulmonary | Inhaled Muscarinic-Antagonists
    • Pulmonary
    • - Inhaled Muscarinic-Antagonists
    5:26 min
    9/13/2022
    29 plays
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