Atrovent, Combivent (ipratropium + salbutamol), Duolin (ipratropium + salbutamol)
PRESENTATION AND ADMINISTRATION:
Atrovent inhaler 20 mcg/dose
Combivent inhaler 20 mcg atrovent per dose and 100 mcg salbutamol per dose
Ipratropium steri-neb 500 mcg/2 mL
Duolin 500 mcg ipratropium and salbutamol 2.5mg per 2.5 mL
2 puffs QID
If ventilated, 5 puffs into circuit via metered dose inhaler adapter
1 vial Ipratropium or Duolin QID
DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:
Dose as in normal renal function
DOSAGE IN PAEDIATRICS:
0.25 - 1 mL of 250 mcg/mL solution diluted to 4 mL
In severe bronchospasm, administer every 20 minutes for 3 doses, then administer 4 - 6 hourly
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.
- Hypersensitivity to ipratropium bromide
- Hypersensitivity to atropine or its derivatives
Immediate hypersensitivity reactions may occur after administration of ipratropium bromide, as demonstrated by rare cases of urticaria, angioedema, rash, bronchospasm, anaphylaxis and oropharyngeal oedema.
Inhaled medicines, including ipratropium bromide, may cause paradoxical bronchospasm. If this occurs, treatment with ipratropium bromide aerosol should be stopped and other treatments.
Ipratropium should be used with caution in patients with narrow-angle glaucoma, prostatic hypertrophy or bladder-neck obstruction.
No tests in addition to routine ICU tests are required.
Drug/Laboratory Test Interactions:
IMPORTANT DRUG INTERACTIONS IN ICU:
None of note
Body as a Whole:
Back pain, headache
Central and Peripheral Nervous System:
Dyspepsia, dry mouth, nausea
Coughing, dyspnoea, rhinitis, sinusitis
Urinary tract infection