1 nebule 500mcg

20 cents

Atrovent, Combivent (ipratropium + salbutamol), Duolin (ipratropium + salbutamol)

  • Bronchospasm

Inh:
Atrovent inhaler 20mcg/dose
Combivent inhaler 20mcg atrovent per dose and 100mcg salbutamol per dose

Neb:
Ipratropium steri-neb 500mcg/2ml
Duolin 500mcg ipratropium and salbutamol 2.5mg per 2.5ml


ADULT DOSE

Inh:
2 puffs 4 times per day or, if ventilated, 5 puffs via metered dose inhaler adaptor into ventilator circuit

Neb:
1 vial of Ipratropium or Duolin four times a day

PAEDIATRIC DOSE

Neb:
0.25-1ml of 250mcg/ml solution diluted to 4ml. In a severe attack administer every 20 minutes for 3 doses then administer 4 to 6 hourly after that.

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY
Dose as in normal renal function

Ipratropium bromide is an anticholinergic (parasympatholytic) agent. Anticholinergics prevent the increases in intracellular concentration of cyclic guanosine monophosphate (cyclic GMP) which are caused by interaction of acetylcholine with the muscarinic receptor on bronchial smooth muscle.

CONTRAINDICATIONS

  • Hypersensitivity to ipratropium bromide

  • Hypersensitivity to atropine or its derivatives.


WARNINGS
Immediate hypersensitivity reactions may occur after administration of ipratropium bromide, as demonstrated by rare cases of urticaria, angioedema, rash, bronchospasm, anaphylaxis and oropharyngeal edema.
Inhaled medicines, including ipratropium bromide, may cause paradoxical bronchospasm. If this occurs, treatment with ipratropium bromide aerosol should be stopped and other treatments

PRECAUTIONS
General
Ipratropium should be used with caution in patients with narrow-angle glaucoma, prostatic hypertrophy or bladder-neck obstruction.

Laboratory Tests:
No tests in addition to routine ICU tests are required.

Drug/Laboratory Test Interactions
None noted.

Body as a Whole
Back pain, headache
Central and Peripheral Nervous System
Dizziness
GI System
Dyspepsia, mouth dry, nausea
Respiratory System
Coughing, dyspnoea, rhinitis, sinusitis
Urinary System
Urinary tract infection

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