Ipratropium bromide (Atrovent)

Trade names Atrovent, Apovent, Ipraxa, Aerovent, Rinatec

An inhalation agent.

Has hepatic metabolism, with protein binding 0 to 9% in vitro.

Half-life of 2 hours.

A drug that relieves bronchial spasms, as it blocks the muscarinic acetylcholine receptors in the smooth muscles of the bronchi in the lungs, opening the bronchi.

Muscarinic antagonists such as ipratropium bromide can also be effective in treating asthma, since acetylcholine is known to cause smooth muscle contraction, especially in the bronchi.

An anticholinergic drug used for the treatment of chronic obstructive pulmonary disease and acute asthma.

Administered by inhalation, and it is supplied in a canister for use in an inhaler or in single dose vials for use in a nebulizer.

Dosage 2 puffs qid.

It is also used to treat and prevent asthma, especially asthma that is accompanied by cardiovascular system diseases.

It is also combined with albuterol.

As a .03% nasal solution sprayed into the nostrils can reduce rhinorrhea, but does not help nasal congestion.

Side effects: dry mouth and sedation, skin flushing, tachycardia, acute angle-closure glaucoma, nausea, palpitations, irritation of the throat, and headache have been observed.

Urinary retention may occur in patients with prostatic hypertrophy.

In combination with beta-adrenergic agonists, as well as theophylline and other xanthine derivatives, increases the dilating effect on the bronchi.

Manifests broncholytic action by reducing cholinergic influence on the bronchial musculature.

Blocks muscarinic acetylcholine receptors promoting the degradation of cyclic guanosine monophosphate (cGMP).

Decreased intracellular concentration of cGMP.

Due to actions of cGMP on intracellular calcium decreases contractility of smooth muscle in the lung, inhibiting bronchoconstriction and mucus secretion.

A nonselective muscarinic antagonist.

Does not diffuse into the blood, preventing systemic side effects.

A derivative of atropine but is a quaternary amine and does not cross the blood�brain barrier, preventing central side effects of anticholinergic syndrome.

Ipratropium is not considered a short-acting bronchodilator.

Not to be used in place of albuterol as a rescue medication.

Not indicated for initial treatment of acute episodes of bronchospasm where rapid response is required.

Should be used with caution in patients with cardiovascular disorders, especially coronary insufficiency, cardiac arrhythmias, and hypertension.

Ipratropium bromide and may increase intraocular pressure which may result in precipitation or worsening of narrow-angle glaucoma.

Ipratropium bromide also may cause urinary retention.

Immediate hypersensitivity reactions may occur after treatment, with rare cases of urticaria, angioedema, rash bronchospasm, oropharyngeal edema and anaphylaxis.

Should be used with caution with narrow angle glaucoma, prostatic hyperplasia or bladder neck obstruction.

Nasal ipratropium substantially improves nasal symptoms in an upper viral respiratory tract infection.

Nasal ipratropium substantially decreases rhinorrhea in upper respiratory infections.

Nasal ipratropium adverse reactions include nasal dryness and epistaxis.

Nasal ipratropium treatment is 2 sprays with 0.06% solution in each nostril four times daily.

Nasal ipratropium does not improve nasal congestion in upper respiratory tract infections.

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