Hear about another COPD treatment option from a Nurse Practitioner

Learn how to improve patient outcomes and experiences with LONHALA® MAGNAIR® (glycopyrrolate) for patients with COPD. Specialties Pulmonary Article

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Hear about another COPD treatment option from a Nurse Practitioner

Nurse Practitioner Dana Hickman, MSN, has been a primary care NP for 32 years. For the past 6 years, she has been dedicated to the treatment of patients with COPD. Learn how she works to improve patient outcomes, and read about her experiences prescribing LONHALA® MAGNAIR® (glycopyrrolate) for her patients with COPD.

LONHALA MAGNAIR is an anticholinergic indicated for the long-term maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema.

How Hickman selects COPD treatment options1

Hickman has a great deal of experience treating patients with COPD in acute-care and LTC settings. When selecting a treatment course for her patients, she weighs many factors to ensure the highest level of care. Among these factors are GOLD guidelines, exacerbation history, and symptom burden. She also takes device features and complexity of disease into consideration. Hickman feels that, more so than with other diseases, finding the optimal treatment for COPD requires more “curious questions” and conversations with patients.


For COPD you really have to look at device delivery selections and individualize it to the patient. COPD is not a linear disease.

In many cases, these factors have led her to prescribe LONHALA MAGNAIR.

Hickman sees progress with LONHALA MAGNAIR1-3

Hickman recalls a particular long-term care (LTC) resident who reminds her of a time when she saw progress with LONHALA MAGNAIR. The resident was male, in his seventies, and cognitively impaired. Because he could not withstand a 15- to 20-minute nebulized administration, he was unable to receive the proper long-acting bronchodilator treatment for his COPD. Then he was prescribed LONHALA MAGNAIR. With its twice daily, 2-3 minute administration (with proper assembly and cleaning)* and use of a natural breathing technique, LONHALA MAGNAIR is an option for many of the active, co-morbid, or cognitively impaired patients who Hickman regularly treats. Because this particular resident was prescribed LONHALA MAGNAIR and received proper assistance with device assembly, maintenance, and use, he was able to better manage his COPD.

Hickman sees progress treating her patients with LONHALA MAGNAIR, as it acts as a bridge between traditional devices, fitting between inhalers and standard jet nebulizers.


Delivery counts; medications are not as effective when patients take them improperly

Hickman’s advice for those considering a new course of treatment1,4

When treating patients with COPD, Hickman stresses the importance of device selection and assessing patient technique. She insists that treatment should be reassessed frequently, and that healthcare providers should take patients’ lung function, cognitive function, and caregiver arrangements into account when considering a new treatment option.


The biggest decision you make is the choice of delivery mechanism that meets your patient’s individual needs and/or preferences. And if you don’t have them show you how they’re using their devices, you’re missing out on an opportunity to impact people’s lives with better disease control.

Hickman recognizes both the rewarding and complex nature of treating COPD: "[It’s] the most rewarding population to work with and it’s so, so challenging.”

GOLD does not endorse any specific treatments.
*Improper cleaning and maintenance may increase administration time.2
Cognitive impairments may also hinder nebulizer setup and maintenance, with which LTC staff may provide assistance. Individual results may vary.5
COPD = chronic obstructive pulmonary disease; GOLD = Global Initiative for Chronic Obstructive Lung Disease.


  1. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Global Initiative for Chronic Obstructive Lung Disease (GOLD). 2020:1-125.
  2. LONHALA MAGNAIR [manufacturer’s instructions for use]. Marlborough, MA: Sunovion Pharmaceuticals Inc.; 2019.
  3. LONHALA MAGNAIR [prescribing information]. Marlborough, MA: Sunovion Pharmaceuticals Inc.; 2019.
  4. Dhand R, Dolovich M, Chipps B, Myers TR, Restrepo R, Farrar JR. The role of nebulized therapy in the management of COPD: evidence and recommendations. COPD. 2012;9(1):58-72.
  5. Zarowitz BJ, O’Shea T. Chronic obstructive pulmonary disease: prevalence, characteristics, and pharmacologic treatment in nursing home residents with cognitive impairments. J Manag Care Pharm. 2012;18(8):598-606.



LONHALA MAGNAIR is contraindicated in patients with a hypersensitivity to glycopyrrolate or to any of the ingredients.

LONHALA MAGNAIR should not be initiated in patients with acutely deteriorating or potentially life-threatening episodes of COPD or used as rescue therapy for acute episodes of bronchospasm. Acute symptoms should be treated with an inhaled short-acting beta2-agonist.

As with other inhaled medicines, LONHALA MAGNAIR can produce paradoxical bronchospasm that may be life-threatening. If paradoxical bronchospasm occurs following dosing with LONHALA MAGNAIR, it should be treated immediately with an inhaled,  short-acting bronchodilator; LONHALA MAGNAIR should be discontinued immediately and alternative therapy instituted.

Immediate hypersensitivity reactions have been reported with LONHALA MAGNAIR. If signs occur, discontinue LONHALA MAGNAIR immediately and institute alternative therapy.

LONHALA MAGNAIR should be used with caution in patients with narrow-angle glaucoma and in patients with urinary retention. Prescribers and patients should be alert for signs and symptoms of acute narrow-angle glaucoma (e.g., eye pain or discomfort, blurred vision, visual halos or colored images in association with red eyes from conjunctival congestion and corneal edema) and of urinary retention (e.g., difficulty passing urine, painful urination), especially in patients with prostatic hyperplasia or bladder-neck obstruction. Patients should be instructed to consult a physician immediately should any of these signs or symptoms develop.

The most common adverse events reported in ≥2% of patients taking LONHALA MAGNAIR, and occurring more frequently than in patients taking placebo, were dyspnea (4.9% vs 3.0%) and urinary tract infection (2.1% vs 1.4%).

LONHALA solution is for oral inhalation only and should not be injected or swallowed. LONHALA vials should only be administered with MAGNAIR.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

For additional information, please see full Prescribing Information and Patient Information for LONHALA MAGNAIR at www.sunovionprofile.com/lonhala-magnair.


LONHALA® MAGNAIR® (glycopyrrolate) is an anticholinergic indicated for the long-term maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema.

LONHALA and symbol.png.f586860aa42807d35a7092d9d4481e14.png are registered trademarks of Sunovion Pharmaceuticals Inc. MAGNAIR is a registered trademark of PARI Pharma GmbH, used under license. SUNOVION and sunovion-icon.png.28cffbf3b5ef3c6fe8a62584c11e36fd.png are registered trademarks of Sumitomo Dainippon Pharma Co., Ltd. Sunovion Pharmaceuticals Inc. is a U.S. subsidiary of Sumitomo Dianippon Pharma Co., Ltd. ©2020 Sunovion Pharmaceuticals Inc. All rights reserved. Sunovion Pharmaceuticals Inc., 84 Waterford Drive, Marlborough, MA 01752. 8/20 LON-US-00070-20

This is a sponsored article brought to you by allnurses.com in conjunction with the advertiser. The views expressed in this article are those of the advertiser and do not necessarily reflect allnurses.com, its parent company, or its staff.

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