UNCONTROLLED WHEN PRINTED
Introduction
  • An anticholinergic bronchodilator. It inhibits the vagal reflexes that mediate bronchospasm.
  • Combined with a nebulised beta-2 agonist (Salbutamol), Ipratropium bromide produces significantly greater bronchodilation than a beta-2 agonist alone. 

Pharmacology Review

Indications

Severe bronchospasm:

Adult: 

Paediatric:

  • Severe to life-threatening asthma
Contraindications
  • Hypersensitivity
Precautions / Notes
  • Glaucoma
  • Avoid contact with eyes.
Management

Adult: 

  • Nebulised (combined with salbutamol):
    • 500mcg in 2ml
    • Repeat nebulised dose every 20mins; maximum of 3 doses.
  • MDI:
    • 12 puffs, 1 breath per puff
    • Administer once only.

Paediatric:

     < 6 years> 6 yearsSubsequent dose if required
    Nebulised250mcg in 1mL500mcg in 2mLRepeat nebulised dose every 20mins; maximum of 3 doses.
    MDI4 puffs, 1 breath per puff8 puffs, 1 breath per puffAdminister once only
Special Considerations
  • Headache.
  • Nausea.
  • Dry Mouth.
  • Skin rash.

References
References
Presentation
  • 250mcg in 1ml nebule
  • Metered Dose Inhaler (MDI)
    20mcg per puff

Atrovent

 

Atrovent-2

 

atrovent

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