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.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.