Ipratropium Bromide CPG

Question 1

Ipratropium Bromide - Presentation

Answer 1

250 mcg in 1 mL nebule or polyamp

Question 2

Ipratropium Bromide - Pharmacology

Answer 2

Anticholinergic bronchodilator

Actions:

• Allows broncodilatation by inhibiting cholinergic bronchomotor tone (i.e. blocks vagal reflexes which mediate bronchoconstriction)

Question 3

Ipratropium Bromide - Metabolism

Answer 3

Excreted by the kidneys

Question 4

Ipratropium Bromide - Primary emergency indications

Answer 4

1. Severe respiratory distress associated with bronchospasm
2. Exacerbation of COPD irrespective of severity

Question 5

Ipratropium Bromide - Contraindications

Answer 5

1. Known hypersensitivity to Atropine or its derivatives

Question 6

Ipratropium Bromide - Precautions

Answer 6

1. Glaucoma
2. Avoid contact with eyes

Question 7

Ipratropium Bromide - Route of administration

Answer 7

Nebulised (in combination with salbutamol)

Question 8

Ipratropium Bromide - 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

Ipratropium Bromide - Special notes

Answer 9

There have been isolated reports of ocular complications (dilated pupils, increased intraocular pressure, acute angle glaucoma, eye pain) as a result of direct eye contact with Ipratropium Bromide formulations.

The nebuliser mask must therefore be fitted properly during inhalation and care taken to avoid Ipratropium Bromide solution entering the eyes.

Ipratropium Bromide must be nebulised in conjunction with Salbutamol and is to be administered as a single dose only.

Onset: 3 - 5min

Peak: 1.5 - 2hrs

Duration: 6hrs