Ipratropium Bromide

Question 1

Generic Name:

Answer 1

Ipratropium Bromide

Question 2

Trade Name:

Answer 2

Atrovent

Question 3

Class:

Answer 3

Anticholinergic, bronchodilator

Question 4

Supplied:

Answer 4

0.5 mg/2.5mL

Question 5

Mechanism of Action:

Answer 5

Anticholinergic (parasympatholytic) agent appears to inhibit vagally-mediated reflexes by antagonizing the action of acetylcholine, the transmitter released from the vagal nerve. (SEE: Notes)

Question 6

Indications and Field Use:

Answer 6

Treatment of bronchospasm associated with chronic obstructive pulmonary disease (emphysema and chronic bronchitis). To be used either alone or in combination with other bronchodilators especially beta adrenergics (i.e., albuterol).

Question 7

Contraindications:

Answer 7

Ipratropium bromide is contraindicated in known or suspected cases of hypersensitivity to ipratropium bromide or to atropine and its derivatives. Precaution: should be used with caution in patients with narrow angle glaucoma.

Question 8

Adverse Reactions:

Answer 8

Resp: Coughing. Sputum increased.

CNS: Dizziness. Insomnia. Tremor. Nervousness

GI: Nausea

Question 9

Incompatibilities/Drug Interactions:

Answer 9

None. Ipratropium bromide has been shown to be safe and effective bronchodilator when used in conjunction with beta adrenergic bronchodilators (albuterol).

Question 10

Adult Dosage:

Answer 10

Give 500 mcg in 2.5 ml normal saline (1 unit dose vial) via SVN with a mouth piece or in-line with a ventilatory device. Repeat according to medical control preference. May mix one unit dose vial of ipratropium with one unit dose vial of albuterol.

Question 11

Pediatric Dosage:

Answer 11

Give 500 mcg in 2.5 ml normal saline (1 unit dose vial) via SVN with a mouth piece or in-line with a ventilatory device. Do not repeat.

Question 12

Routes of Administration:

Answer 12

• Nebulized, mouth piece or in-line

- Inhaler, patients own

Question 13

Onset of Action:

Answer 13

5 to 15 minutes

Question 14

Peak Effects:

Answer 14

60 to 120 minutes

Question 15

Duration of Action:

Answer 15

4 to 8 hours

Question 16

Arizona Drug Box Minimum Supply:

Answer 16

5 mL

Question 17

Special Notes:

Answer 17

• Anticholinergics produce preferential dilatation of the larger central airways, in contrast to beta agonists, which affect the peripheral airways. May be more effective used in combination with beta agonists.
•  Should be kept out of light in foil pouch and avoid excessive humidity.