Patient/caregiver was educated on contraindications for using Spiriva as follows:
- Spiriva use can result in elevated heart rate and consequent high blood pressure. Individuals with history of tachycardia and poorly controlled hypertension can be at increased risk for grossly elevated heart rate and high blood pressure with Spiriva. Spiriva must be used with extra caution in individuals with history of poorly controlled hypertension, with close watch maintained on blood pressure numbers, to prevent exacerbation of HTN and consequent chest pain, palpitations, and risk for stroke.
- Spiriva is minimally metabolized in the liver and a significant portion of the drug administered is excreted unchanged in urine. Individuals with compromised renal function cannot excrete the medication normally, which allows the medication to stay in blood circulation for longer time, resulting in toxicity and consequent side-effects. So, Spiriva must be used with caution in individuals with compromised renal function, with possible dose adjustments, periodical monitoring for renal functions, and close watch for development of any dangerous side-effects and toxicity symptoms with the medication.
