Home Drug Guide Ipratropium Bromide

Drug Guide

Generic Name

Ipratropium Bromide

Brand Names Atrovent, Atrovent Hfa

Classification

Therapeutic: Respiratory agent, Bronchodilator

Pharmacological: Anticholinergic (Muscarinic receptor antagonist)

FDA Approved Indications

Chronic obstructive pulmonary disease (COPD)
emphysema
chronic bronchitis

Mechanism of Action

Ipratropium Bromide blocks the action of acetylcholine on muscarinic receptors in the airway smooth muscle, leading to bronchial dilation.

Dosage and Administration

Adult: Inhalation of 0.2 mg via metered-dose inhaler (MDI) 3-4 times daily. For nebulization, 0.5 mg 3-4 times daily.

Pediatric: Children 6 years or older: 0.25-0.5 mg via nebulizer 3-4 times daily. Adjust based on response.

Geriatric: Use with caution, as with all respiratory medications, and monitor for adverse effects.

Renal Impairment: Use with caution; no specific dosage adjustment has been established.

Hepatic Impairment: No specific guidance available.

Pharmacokinetics

Absorption: Minimal systemic absorption from inhalation routes.

Distribution: Widely distributed in tissues after inhalation.

Metabolism: Metabolized in the liver via ester hydrolysis.

Excretion: Excreted mainly in urine and feces.

Half Life: Approximate terminal half-life: 1.6 hours.

Contraindications

Hypersensitivity to ipratropium or other atropine derivatives.
Use with caution in patients with urinary retention, BPH, glaucoma.
Avoid in patients with soy or peanut allergy (due to excipients).

Precautions

Use cautiously in patients with cardiovascular disease, urinary retention, glaucoma. Monitor for anticholinergic side effects.

Adverse Reactions - Common

Dry mouth (Common)
Pharyngeal irritation (Common)
Cough (Common)

Adverse Reactions - Serious

Paradoxical bronchospasm (Rare)
Allergic reactions (rash, urticaria, anaphylaxis) (Rare)

Drug-Drug Interactions

Additional anticholinergic agents (increased anticholinergic effects)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor respiratory status and lung sounds, baseline pulmonary function tests.

Diagnoses:

Impaired gas exchange
Ineffective airway clearance

Implementation: Administer via inhaler or nebulizer as prescribed. Educate patient on proper inhaler technique.

Evaluation: Assess for improvement in symptoms, lung function, and adverse effects.

Patient/Family Teaching

Use inhaler/spacer correctly to ensure proper dosing.
Report any signs of allergic reactions, paradoxical bronchospasm.
Maintain regular follow-up appointments.

Special Considerations

Black Box Warnings: N/A

Genetic Factors: None specific.

Lab Test Interference: None.

Overdose Management

Signs/Symptoms: Dry mouth, blurred vision, urinary retention, tachycardia, worsening bronchospasm.

Treatment: Discontinue drug, provide symptomatic treatment, and supportive care. In case of overdose, activated charcoal may be considered if ingestion was recent.

Storage and Handling

Storage: Store at room temperature, away from light and moisture.

Stability: Stable until expiration date on package.