Ipratropium Flashcards
What is the MOA for Ipratropium?
- Ipratropium is a vasodilator
- It is an anticholergenic agent with antimuscarinic properties - it blocks acetylcholine receptors causing vagal inhibition resulting in bronchodilation
(acetylcholine can stimulate bronchoconstriction Muscarinic antagonists (anti-cholinergics): Blocking the muscarinic acetylcholine receptors in pulmonary smooth muscle tissue results in a decrease in smooth muscle tone and bronchodilation. These medications include short-acting muscarinic antagonists (SAMAs) such as ipratropium, and long-acting muscarinic antagonists (LAMA) such as tiotropium. Onset of action for SAMAs is typically between 30–60 minutes, making these drugs less efficacious in treating acute asthma attacks and bronchospasm.)
What are the indications for ipratropium?
- Bronchospasm secondary to athma or CORD
2. Prominanent bronchospasm secondary to airway burns or smoke inhalation
What are the contraindications/cautions for Ipratropium?
Contra: known severe allergy
Cautions: None
Pregnancy/breastfeeding: should be administered if indicated, breastfeeding should stop
What is the doseage for Ipratropium?
0.5mg once only nebulised in combination with 5 mg salbutamol
What is the onset and duration of Ipratropium
2-5 minutes with an effect of 6 hours
What are the common adverse effects of ipratropium?
Tachycardia
Dry mouth
Blurred vision
Contrast treatment for mild, moderate, severe and life threatening asthma.
*Mild/moderate 5mg salbutomal with 0.5mg ipratropium neb + 40mg prednisone PO. With mild can use MDI bronchodilators instead and if improving tpt may not be required.
*Severe: bronchodilators as above with addition of IM adrenaline if no improvement repeat every 10 min if no IV access. In lifethreatening cases salbutomol neb should be continuous.
In all cases IV access for adrenaline infusion will be required if asthma not improving
