Ipratropium

Question 1

Class

Answer 1

Anticholinergic, bronchodilator

Question 2

Mechanism of Action

Answer 2

Inhibits interaction of acetylcholine at receptor sites of bronchial smooth muscle, resulting in decreased cyclic guanosine monophosphate and bronchodilation

Question 3

Contraindications

Answer 3

Hypersensitivity to ipratropim, atropine, alkaloids, peanuts

Question 4

Adverse reactions / side effects

Answer 4

headache, dizziness, nervousness, fatigue, tremor, blurred vision, cough, dyspnea, worsening COPD, symptoms, tachycardia, palpitations, flushing, MI, dry mouth, nausea, vomiting, GI distress.

Question 5

Drug interactions

Answer 5

none reported

Question 6

Adult dose

Answer 6

250 to 500 mcg via inhalation with handheld nebulizer every 20 minutes up to 3 times

Question 7

Pedi dose

Answer 7

250 to 500 mcg via inhalation with handheld nebulizer every 20 minutes up to 3 times

Question 8

Duration of Action

Answer 8

Onset: 1 to 3 minutes. Peak effect 90 to 120 minutes. Duration: 4 to 6 hours

Question 9

Pregnancy class

Answer 9

B

Question 10

Specical considerations

Answer 10

When used in combination with beta - agonists ( eg, metaproterenol and albuterol), the beta agonist is always administered first with a 5 minute wait before administering ipratropium. Shake well before use. Use with caution in patients with urinary retention.

Question 11

Indications

Answer 11

Persistent bronchospasm, COPD exacerbation