Tiotropium
"Was prescribed Spiriva dry powder capsules in May of 2015, this was during a bout of atypical pneumonia which I had weeks before being prescribed Sprivia, and lingered  for weeks after.  As a result of the illness I suffered pulmonary exacerbation which brought about COPD symptoms to the point that now 8 months later I have to use Oxygen [2.LPM] 24/7. It has been taxing and shocking but the  Spiriva along with Symicort [80/4.5] does help, I measure my O2 Blood saturation several times daily, I have experimented with halting one and both medications over small periods of times and have realized that I can do without the Symicort with not much variation in the O2 Saturation, bit when the  Spiriva is halted for 48 hours the O2 Saturation drops"