Tiotropium is a white solid chemical. Chemical name (1R,2R,4S,5S,7S)-7-[2-hydroxy-2, 2-bis (2-thiophenyl) acetoxy]-9, 9-dimethyl-3-epoxy-9-nitrogen cationic tricycloctane [3.3.1.02.4] nonane bromide, molecular formula C19H22BrNO4S2, Molecular weight 472.41600, white or light yellow white powder. Slightly soluble in water, soluble in methanol. Tiotropium is an anticholinergic bronchodilator, which is mainly used in the maintenance treatment of chronic obstructive pulmonary diseases, including the maintenance treatment of chronic bronchitis, emphysema with dyspnea and the prevention of acute attacks.
hemical construction：
Structural characteristics of
Tiotropium is derived from the quaternization of anisodamine and the transformation of its tropic acid into dithiaphenol hydroxyacetic acid.
indications
Dry powder is suitable for the maintenance treatment of reversible airway obstruction and COPD, but not for the relief of chronic bronchospasm.
Side effects
(1) Some patients developed allergic reactions (including rash, urticaria and angioedema) after taking the drug.
(2) Long-term use is not easy to produce drug resistance, can cause dry mouth and bitter taste. Inhalation irritation can also cause bronchospasm, blurred vision, glaucoma.
contraindicated
(1) To tiotropium bromide allergy is contraindicated.
(2) Allergic to atropine and its derivatives (such as ipratropium bromide, oxytroponium bromide) should not be used.
(3) It is not recommended for pregnant and lactating women.
Drug interaction
The concomitant use of tiotropium with other anticholinergic agents has not been studied and is therefore not recommended.
Matters needing attention
(1) Tiotropium, as a bronchodilator for once-daily maintenance therapy, should not be used for the initial treatment of acute episodes of bronchospasm, i.e., rescue therapy.
(2) As with other anticholinergic agents, they should be used with caution in patients with narrow-angle glaucoma, prostatic hyperplasia, or bladder neck obstruction.
(3) Inhalation of drugs may cause aspiration bronchospasm.
Usage.
Inhalation, 18μg, once a day. It is usually used every morning or noon.
