Ipratropium Bromide
Indications
Ipratropium Bromide is used for:
Asthma, chronic obstructive pulmonary disease, chronic bronchitis, emphysema.
Adult Dose
Inhalation
Asthma; Chronic obstructive pulmonary disease
Adult: As Inhaler: Adults: 1-2 puffs (20 mg/puff) 3-4 times daily. Single doses of up to 80 mcg may be required in some patients.
As nebulized soln
250-500 mcg 3-4 times daily.
Child Dose
Inhalation
Asthma; Chronic obstructive pulmonary disease
Child: As metered-dose aerosol:
<6 yr 20 mcg tid;
6-12 yr 20-40 mcg tid.
As soln for nebulisation:
<6 yr For acute asthma: 125-250 mcg, given no more often than 6 hrly up to a total dose of 1 mg.
6-12 yr For acute and chronic asthma: 250 mcg, repeated as necessary up to a total dose of 1 mg.
Renal Dose
Administration
Contra Indications
Ipratropium Bromide solution should not be taken by patients with known hypersensitivity to atropine or its derivatives or to any other component of the product.
Precautions
Bladder neck obstruction, narrow-angle glaucoma or patients susceptible to glaucoma, prostatic hyperplasia. Protect patient's eyes from nebulised drug. Renal and hepatic impairment. Pregnancy, lactation, children, elderly.
Pregnancy-Lactation
Pregnancy category: B
Lactation: Unknown whether drug is excreted in breast milk
Interactions
Increased toxicity with other anticholinergic drugs.
Adverse Effects
Side effects of Ipratropium Bromide :
Dry mouth, urinary retention, buccal ulceration, paralytic ileus, headache, nausea, constipation, paradoxical bronchospasm, immediate hypersensitivity reactions (urticaria, angioedema), acute angle-closure glaucoma.
Potentially Fatal: Anaphylactic reactions, atrial fibrillation, supraventricular tachycardia.
Mechanism of Action
Ipratropium bromide blocks the action of acetylcholine at parasympathetic sites in bronchial smooth muscle causing bronchodilation.