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Viewpoint: "4 mL b.i.d."

Authors present a case that illustrates the importance of patient counseling to avoid drug errors.

The FDA recently approved tiotropium (Spiriva HandiHaler, Pfizer/Boehringer-Ingelheim) inhalation powder for the long-term, once-daily, maintenance treatment of bronchospasm associated with COPD, including bronchitis and emphysema. In the airways, tiotropium inhibits muscarinic (M3) receptors at the smooth muscle, leading to bronchodilation. The manufacturer anticipates that tiotropium will be available in pharmacies by mid-year.

States are up in the air about their discount card programs following the passage of the Medicare drug benefit legislation, which has a provision for an Rx card program