Ipratropium bromide Flashcards
What is the trade name for ipratropium bromide?
Atrovent
What is the drug classification for ipratropium bromide (Atrovent)?
anti-cholinergic; bronchodilator
How is ipratropium bromide (Atrovent) supplied?
- 250 mcg or 500 mcg in 2.5 mL nebula
- MDI 17 & 18 mcg/spray
Describe the MOA (pharmacodynamics) of ipratropium bromide (Atrovent).
Actions (Pharmacodynamics):
❑ Anticholinergic action: Appears to inhibit vagally mediated reflexes by antagonizing the action of acetylcholine.
Anticholinergics prevent the increase in intracellular concentration of cyclic guanosine monophosphate (cGMP) that results from interaction of acetylcholine with the Muscarinic receptor on bronchial smooth muscle.
❑ Bronchodilation action: following inhalation is primarily a local, site specific effect, not systemic one. Blocks action of acetylcholine and muscarinic receptors (parasympathetic sites) on bronchial smooth muscles.
What are the indications for use of ipratropium bromide (Atrovent)?
Bronchospasm in asthma, anaphylaxis, bronchitis, and emphysema
What is the ADULT dosing for ipratropium bromide (Atrovent)?
NEB: 500 mcg q 5 - 15 minutes to Max 1500 mcg
MDI: 5 puffs (20 mcg/puff) with spacer q 5 to 15 minutes prn to max of 15 puffs
What is the PEDIATRIC dosing for ipratropium bromide (Atrovent)?
NEBS:
<10 kg = 125 mcg
10 - 20kg = 250 mcg
>20 kg = 500 mcg
MDI:
5 - 12 y/o = 1 to 2 puffs q6h Max 8 puffs/day
12 - 18 y/o = 2 to 3 puffs q6h Max 12 puffs/day
How should an MDI be administered?
Wait 30 seconds between each puff to allow MDI to recharge; invert canister numerous times and depress canister 3 times, directed away from pt, prior to administration; as pt begins to inhale deliver one puff into the chamber; allow pt to breathe into the chamber 5 times before removing it; instruct pt hold their breath for 5 – 10 seconds with each inhale.
What are the contraindications to ipratropium bromide?
- Hypersensitivity to drug or atropine or its derivatives
- Hypersensitivity to soy lecithin or related food products (soybeans)
What is a precaution to ipratropium bromide (Atrovent) usage?
Patients with narrow angle-closure glaucoma
What could happen if you accidently spray ipratropium bromide (Atrovent) into your patients eye?
Temporary blurred vision and pupil dilation may result
How long does ipratropium bromide remain stable when mixed with salbutamol?
It remains stable for approx 1hr
*This seems to contradict the combi-vent nebs we carry on car, but that is what the formulary read. They add something to keep it stable?
Can ipratropium bromide (Atrovent) cause dry mouth?
Yes of course, it’s an anticholinergic.
Why is ipratropium bromide (Atrovent) often combined with salbutamol?
Because ipratropium bromide and beta2-adrenergic agonists promote bronchodilation by different mechanisms, their beneficial effects are additive, hence combined use makes sense. MDI use, alternate single puffs with salbutamol during recharge periods.
