United States local tolerance

In the United States, food safety is an important responsibility not only of the Food and Drug Administration (FDA), but also of the U.S. Department of Agriculture (USDA), the Environmental Protection Agency (EPA), and other agencies at the federal, state, and local levels. The EPA registers or approves the use of pesticides and establishes a tolerance level if the use of a pesticide may lead to residues in food (30). 

When inhaled, tiotropium is minimally absorbed into the systemic circulation and results in bronchodilation within 30 minutes, with a peak effect in 3 hours. Bronchodilation persists for at least 24 hours. In the United States, it is delivered via the HandiHaler, a single-load, dry-powder, breath-actuated device. Because it acts locally, tiotropium is well tolerated, with the most common complaint being a dry mouth. Other anticholinergic side effects that are reported include constipation, urinary retention, tachycardia, blurred vision, and precipitation of narrow-angle glaucoma symptoms. 

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