Ipratropium Bromide

Question 1

Presentation

Answer 1

250 mcg in 1 ml nebule or polyamp

Question 2

Pharmacology

Answer 2

Anticholinergic bronchodilator

Actions:

• allows bronchodilatation by inhibiting cholinergic bronchomotor tone
• ie: blocks vagal reflexes which mediate bronchoconstriction

Question 3

Metabolism

Answer 3

Excreted by the kidneys

Question 4

Indications

Answer 4

• Severe respiratory distress associated with bronchospasm

- Exacerbation of COPD irrespective of severity

Question 5

Contras

Answer 5

Known hypersensitivity to atropine or its derivatives

Question 6

Precautions

Answer 6

• glaucoma

- avoid contact with eyes

Question 7

Route of administration

Answer 7

nebulised (in combination with salbutamol)

Question 8

Side effects

Answer 8

• headache
• nausea
• dry mouth
• skin rash
• tachycardia (rare)
• palpitations (rare)
• acute angle closure glaucoma secondary to direct eye contact (rare)

Question 9

Special notes

Answer 9

Isolated reports of ocular complications with direct eye contact

• dilated pupils
• increased intraocular pressure
• acute angle glaucoma
• eye pain

Nebuliser mask must be fitted properly and care taken to avoid solution entering eyes

Nebulise in conjunction with salbutamol and single dose only

Question 10

Nebulised effects

Answer 10

Onset: 3-5 mins
Peak: 1.5-2 hrs
Duration: 6 hrs

Question 11

Severe Asthma

Answer 11

Adult
- 500 mcg nebulised - single dose only

Peadiatric
- 250 mcg nebulised - single dose only

Question 12

Exacerbation of COPD

Answer 12

500 mcg nebulised - single dose only