Names and pronunciation
(rev′e-fen′a-sin) Yupelri
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Drug reference
(rev′e-fen′a-sin) Yupelri
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Func. class.: Respiratory muscarinic antagonists—long-acting
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ACTION: In airways, it exhibits phar macologic effects through inhibition of the M3 receptor at the smooth muscle, leading to bronchodilation
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USES: Maintenance treatment of those with COPD
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CONTRAINDICATIONS: Hyper sensitivity Precautions: Acute/paradoxical bron- chospasm, acutely deteriorating COPD, acute symptoms, other anticholinergics, breastfeeding, cardiac disease, children, closed-angle glaucoma, dementia, driv- ing or hazardous tasks, geriatric patients, hepatic disease, ocular exposure, preg- nancy, prostatic hypertrophy, urinary retention/obstruction
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SIDE EFFECTS CNS: Headache RESP: Cough, nasopharyngitis, upper respiratory tract infection, bronchospasm MS: Back pain EENT: Ocular hypertension INTEG: Angioedema, anaphylaxis
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INTERACTIONS Increase: anticholinergic effect—other anticholinergics; avoid coadministration Increase: revefenacin effect—OATP1B1, OATP1B3 inhibitors (rifampicin, cyclo- sporine); avoid coadministration
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DOSAGE AND ROUTES • Adult: INH 1 175-mcg vial (3 mL) once daily, by oral inhalation only
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Available forms: 175 mcg/3 mL sol for inhalation Administer Oral inhalation route • Give by oral inhalation via nebulizer only; do not swallow, no dilution neces- sary, single-dose vials are ready-to-use • Remove the unit-dose vial from the foil pouch only immediately before use; product should be colorless; discard if the solution is not colorless • Do not mix with other drugs • Give the inhalation solution via a stan- dard jet nebulizer connected to an air compressor; give over 8 min • Discard the vial and any residual solu- tion after use
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Evaluate: • Therapeutic response: prevention or relief of the symptoms of COPD Teach patient/family • To contact health care provider if symp- toms are not relieved or if shortness of breath continues or if bronchospasm occurs • To notify health care provider of all OTC preparations, other medications, herbs, and supplements taken; not to start or stop products without approval of provider • Not to swallow during nebulization • That pulmonary function tests will be monitored periodically • Pregnancy/breastfeeding: to inform health care provider if pregnancy is planned or suspected, or if breastfeeding
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CLINICAL CONSIDERATIONS Assess • Respiratory status: lung sounds, pulse, B/P before and after product is given; note wheezing, shortness of breath, cough; monitor pulmonary func- tion tests baseline and periodically • Pregnancy/breastfeeding: no well- controlled studies; animal studies showed no evidence of fetal harm; an- ticholinergics suppress lactation
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PHARMACOKINETICS Extensively distributed to tissues, primar- ily metabolized via hydrolysis to a metab- olite, half-life of active metabolite 22-70 hr, excreted 54% feces, 27% urine
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• Adult: INH 1 175-mcg vial (3 mL) once daily, by oral inhalation only
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