ipatropium bromide [Atrovent]

Question 1

Classification

ipatropium bromide

Answer 1

• bronchodilator
• anticholinergic
• muscarinc antagonist

Question 2

INDICATIONs

ipatropium bromide

Answer 2

PCP
- severe bronchospasm in asthma or COPD

PCP requires scope expansion education

Question 3

CONTRAINDICATIONs

ipatropium bromide

Answer 3

• HYPERSENSITIVITY

Question 4

Dosage - Adult

ipatropium bromide

Answer 4

PCP
160mcg (20mcg x 8) dose via MDI w/ spacer
500mcg - nebulized combined w/ salubutamol in nebulizer for co-administration

MDI w/ space strongly recommened for ILI pts or other infectious respiratory conditions

single dose only

Question 5

Dosage - Pediatric

ipatropium bromide

Answer 5

PCP - ☎️ cliniCALL required for care planning

via NEB
250mcg (half nebule) - total volume 5mL

via MDI
80mcg (20mcg x 4)

< 30 days - neonates - NOT indicated

Question 6

Pharmacodynamic

ipatropium bromide

Answer 6

• antagonizes the acitivity of acetylcholine in bronchial smooth muscle, produing bronchodilation and muscle relaxation

Question 7

Pharmacokinetics

ipatropium bromide

Answer 7

inhaled
onset - 3-15mins
peak - 90-120mins
duration - 6hrs

Question 8

Warnings // Precautions

ipatropium bromide

Answer 8

use w/ caution in pts w/
* narrow-angle glaucoma - increases intraocular pressure
* prostatic hyperplasia - bladder neck obstruction - may cause urinary retention

not monotherapy for acute bronchospasm - to be used w/ salbutamol

Question 9

ADVERSE EFFECTs

ipatropium bromide

Answer 9

similar to other anticholinergics
- atrial arrhythmias
- blurred vision
- coughing
- paradoxical bronchospam (uncommon) - typically occurs upon initial use of Atrovent

Question 10

OVERDOSE

ipatropium bromide

Answer 10

very high doses (up to 1.2mg) w/o development of serious systemic side effects