رجل عمره ٧٣ سنة عنده انسداد رئوي مزمن، والطبيب بدأ له تيوتروبيوم بخاخ يومياً. عند مراجعة تاريخه، وجد الممرض عدة أمراض مزمنة. التشبع ٩٣٪، والضغط ١٣٢/٨٠. أي تاريخ مرضي عنده يحتاج الحذر مع هذا الدواء؟

A 73-year-old man with COPD is started on daily inhaled tiotropium. Reviewing his history, the nurse finds several chronic conditions. SpO2 93%, BP 132/80. Which history requires caution with this drug?

1. An enlarged prostate with urinary hesitancy
2. A long-standing deficiency of vitamin D
3. High blood cholesterol
4. Allergy to dust and house mites

Answer: A) An enlarged prostate with urinary hesitancy. Tiotropium is anticholinergic and can worsen urinary retention with an enlarged prostate and raise eye pressure in angle-closure glaucoma. Clients avoid getting the powder in their eyes.