Ipratropium Bromide

• Ipratropium Bromide

• Atrovent

Classification:

• Anticholinergic agent, bronchodilator

Mechanism of Action:

• Binds antagonistically to the muscarinic acetylcholine receptor inhibiting the parasympathetic nervous system in airways leading to bronchodilation and fewer secretions.

Indications:

• Bronchoconstriction

Contraindications:

•  Hypersensitivity

Precautions:

• Patients with/taking: Narrow angle glaucoma, Myasthenia Gravis, bladder neck obstruction, prostatic hypertrophy

Adverse Effects:

• Tachycardia, palpitations
• Headache
• Dizziness
• Anxiety
• Nausea/vomiting
• Blurred vision

Dose:

• MDI: 4-8 puffs q 5 mins PRN
• NEB: 250-500 mcg q 5 mins (max 3 doses)

• MDI: 2-3 puffs q 5 mins PRN
• NEB: 125-500 mcg with salbutamol or NS

• May be given by metered dose inhaler (MDI)
• MDI can be administered via CPAP or BVM utilizing either a built in MDI port or an MDI adapter

• Metered dose inhaler (canister with plastic inhaler device)
  • 20 mcg per metered dose (puff)

• A spacer (holding chamber) should be used when administering by MDI directly to the patient (i.e., when not administered through the MDI adapter or port).
• 2 puffs are equivalent to approximately a 250 mcg nebule.
• Atrovent is most commonly given in conjunction with a beta-agonist.
• If a patient has access to an MDI in the home, use the patient’s own supply.
• Pregnancy category B [if there is a clinical need for it, Category B drugs are considered safe to use

• Compendium of Pharmaceuticals and Specialties (CPS)
• Atrovent HFA drug monograph