Medication profile reviewed and reconciled. SN reviewed and instructed patient on medication regimen of spirivia. Instructed patient that medication is used for maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD). Spiriva HandiHaler is indicated to reduce exacerbations in COPD patients. Instructed patient that, with administration of Spiriva HandiHaler, a Spiriva capsule is placed into the center chamber of the HandiHaler device. The capsule is pierced by pressing and releasing the green piercing button on the side of the HandiHaler device. The tiotropium formulation is dispersed into the air stream when its inhaled through the mouthpiece. Instructed to inhale once or twice to get al medication inhaled. Instructed patient that dry mouth or constipation may occur. Instructed to notify MD/SN right away if any serious side effects, including: vision changes (such as blurred vision, seeing halos), eye pain, difficult/painful urination, fast heartbeat.