A patient with COPD is prescribed tiotropium [Spiriva]. After the initial dose, the patient reports only mild relief within 30 minutes. What will the nurse tell the patient?
a. "You may have another dose in 4 hours."
b. "You may need to take two inhalations instead of one."
c. "You should have peak effects in about 6 hours."
d. "You should see improved effects within the next week."
D
Tiotropium shows therapeutic effects in about 30 minutes, with improved bronchodilation occur-ring with subsequent doses, up to 8 days. The medication is given once daily, with inhalation of one capsule. Peak effects occur in 3 hours.
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