Ipratropium Bromide

Question 1

Classification of Drug

Answer 1

Anticholinergic

Question 2

Action (unclear whether we need this)

Answer 2

Blocks action of acetylcholine at parasympathetic sites in bronchial smooth muscle, resulting in bronchodilation

Question 3

Indications for usage

Answer 3

Bronchospasm (associated with SOB)

Question 4

Contraindications

Answer 4

Hypersensitivity to atropine (or derivatives), or ipratropium bromide (or any of its components)

Question 5

Cautions

Answer 5

• Acute bronchospasm (not indicated to be used alone for emerg. scenes)
• Bladder-neck obstruction, glaucoma (narrow-angle), prostatic hyperplasia may be precipitated or worsened
• If hypersensitivity reaction occurs, discontinue if this is the case
• Intraocular pressure increases may occur
• Paradoxical bronchospasm may occur (discontinue if so)

Question 6

Dosage (Adult and Pediatric)

Answer 6

MDI (Adult and Pedi): 4 x 20mcg, may repeat once (max of 160mcgs)
Nebulized (Adult): 0.5 mg (w/Ventolin)
Nebulized (Pedi): 0.25 to 0.5 mg (w/Ventolin)

Question 7

Flow rate of oxygen in nebulizer?

Answer 7

6-8Lpm

Question 8

Side Effects

Answer 8

Blurred vision, coughing, urinary retention, paradoxical bronchospasm