General

Pronunciation:
oh-loh-dat-er-ole


Trade Name(s)

  • Striverdi

Ther. Class.
bronchodilators

Pharm. Class.
beta-adrenergic agonists

Indications

Maintenance treatment of airflow obstruction in patients with COPD including chronic bronchitis and emphysema.

Action

A long-acting beta2 -adrenergic agonist (LABA) that stimulates adenyl cyclase, resulting in accumulation of cyclic adenosine monophosphate (cAMP) at beta2 -adrenergic receptors resulting in bronchodilation.

Therapeutic Effect(s):

Bronchodilation with decreased airflow obstruction.

Pharmacokinetics

Absorption: 30% absorbed following oral inhalation (from lung surface); swallowed drug is minimally absorbed.

Distribution: Extensive tissue distribution; probably enters breast milk.

Metabolism and Excretion: Extensively metabolized (some by CYP 3A4), only one metabolite binds to B2 adrenergic receptors. Following inhalation, 5–7% excreted unchanged in urine, remainder in feces as drug and metabolites (84%).

Half-life: 45 hr (following inhalation).

TIME/ACTION PROFILE (improvement in FEV1)

ROUTEONSETPEAKDURATION
inhalnwithin 1 hr1–5 hr24 hr

Contraindication/Precautions

Contraindicated in:

  • Severe/acute/deteriorating symptoms of airflow obstruction.

Use Cautiously in:

  • History of seizures;
  • Thyrotoxicosis;
  • History of cardiovascular disorders (coronary insufficiency, arrhythmias, hypertension);
  • Sensitivity to sympathomimetics (adrenergics);
  • Severe hepatic impairment;
  • OB: Use during pregnancy only if potential benefit justifies potential risk to the fetus;
  • Lactation:Use cautiously if breast feeding (probably enters breast milk);
  • Pedi: Safe and effective use in children has not been established.

Exercise Extreme Caution in:

Concurrent use with MAOIs, tricyclic antidepressants, or drugs that prolong QTc (↑ risk of adverse cardiovascular reactions).

Adverse Reactions/Side Effects

CNS: dizziness .

EENT: nasopharyngitis

Resp: PARADOXICAL BRONCHOSPASM, cough

CV: ↑ BP, ECG changes, tachycardia

GI: diarrhea

Endo: hyperglycemia

F and E: hypokalemia

MS: arthralgia, back pain

Misc: HYPERSENSITIVITY REACTIONS INCLUDING ANGIOEDEMA

* CAPITALS indicate life-threatening.
Underline indicate most frequent.

Interactions

Drug-Drug

  • Concurrent use with MAOIs, tricyclic antidepressants, or drugs that prolong QTc ↑ risk of adverse cardiovascular reactions (use with extreme caution).
  • Concurrent use of other adrenergics ↑ risk of adverse adrenergic adverse reactions (tachycardia, ↑ BP).
  • Concurrent use with corticosteroids, non-potassium sparing diuretics, or xanthine derivatives (including theophylline) may ↑ risk of hypokalemia and adverse cardiovascular reactions (use cautiously).
  • Concurrent use with beta blockers may ↓ effectiveness and cause severe bronchospasm (use cautiously).
  • Should not be used concurrently with any other long-acting beta2 -adrenergic blockers (LABAs)
  • Blood levels may be ↑ by ketoconazole.

Route/Dosage

Inhaln: (Adults) 2 inhalations once daily.

Availability

Inhalation spray: 2.7 mcg (delivers 2.5 mcg) per actuation in cartridges containing 14 doses/cartridge (one actuation lost in priming) for use with Respimat inhaler

Assessment

  • Assess respiratory status (rate, breath sounds, degree of dyspnea, pulse) before administration and at peak of medication. Consult health care professional about alternative medication if severe bronchospasm is present; onset of action is too slow for patients in acute distress. If paradoxical bronchospasm (wheezing) occurs, withhold medication and notify health care professional immediately.
  • Monitor for signs and symptoms of allergic reactions (difficulties in breathing or swallowing, swelling of tongue, lips and face, urticaria, skin rash). Discontinue therapy if symptoms occur.

Lab Test Considerations:

May cause transient hypokalemia and hyperglycemia.

Potential Diagnoses

Implementation

  • Inhaln: Prior to first use, prime the inhaler by actuating toward ground until aerosol cloud is visible, then repeat procedure 3 more times. If not used for 3 days, actuate inhaler once to prepare for use. Striverdi Respimat has a slow-moving mist to assist with inhalation. Use once (2 puffs), at the same time daily.
    • A rescue inhaler of short-acting beta2 -agonists should always be available to treat sudden bronchospasm.

Patient/Family Teaching

  • Instruct patient in the correct use of Striverdi Respimat. Take missed doses as soon as remembered. Do not take more than 1 dose (2 puffs) in 24 hr. Advise patient not to discontinue without consulting health care professional; symptoms may recur.
  • Inform patient that olodaterol is a long-acting bronchodilator and should not be used for treating sudden breathing problems.
  • Advise patient to notify health care professional if signs and symptoms of allergic reaction, worsening symptoms; decreasing effectiveness of inhaled, short-acting beta2 –agonists; need for more inhalations than usual of inhaled, short-acting beta2 -agonists; or significant decrease in lung function occur.
  • Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to avoid concurrent use of Rx, OTC, and herbal products without consulting health care professional.
  • Advise female patient to notify health care professional if pregnancy is planned or suspected or if breast feeding.

Evaluation/Desired Outcomes

Bronchodilation with decreased airflow obstruction.

olodaterol is a sample topic from the Davis's Drug Guide.

To view other topics, please or purchase a subscription.

Nursing Central is the award-winning, complete mobile solution for nurses and students. Look up information on diseases, tests, and procedures; then consult the database with 5,000+ drugs or refer to 65,000+ dictionary terms. Learn more.

Citation

* When formatting your citation, note that all book, journal, and database titles should be italicized* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - olodaterol ID - 110179 A1 - Quiring,Courtney, AU - Sanoski,Cynthia A, AU - Vallerand,April Hazard, BT - Davis's Drug Guide UR - https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Drug-Guide/110179/all/olodaterol PB - F.A. Davis Company ET - 16 DB - Nursing Central DP - Unbound Medicine ER -