Ipratropium Bromide

Indications

Ipratropium Bromide is used for: Asthma, chronic obstructive pulmonary disease, chronic bronchitis, emphysema.

Adult Dose

Inhalation Asthma; Chronic obstructive pulmonary disease Adult: As Inhaler: Adults: 1-2 puffs (20 mg/puff) 3-4 times daily. Single doses of up to 80 mcg may be required in some patients. As nebulized soln 250-500 mcg 3-4 times daily.

Child Dose

Inhalation Asthma; Chronic obstructive pulmonary disease Child: As metered-dose aerosol: <6 yr 20 mcg tid; 6-12 yr 20-40 mcg tid. As soln for nebulisation: <6 yr For acute asthma: 125-250 mcg, given no more often than 6 hrly up to a total dose of 1 mg. 6-12 yr For acute and chronic asthma: 250 mcg, repeated as necessary up to a total dose of 1 mg.

Renal Dose

Administration

Contra Indications

Ipratropium Bromide solution should not be taken by patients with known hypersensitivity to atropine or its derivatives or to any other component of the product.

Precautions

Bladder neck obstruction, narrow-angle glaucoma or patients susceptible to glaucoma, prostatic hyperplasia. Protect patient's eyes from nebulised drug. Renal and hepatic impairment. Pregnancy, lactation, children, elderly.

Pregnancy-Lactation

Interactions

Increased toxicity with other anticholinergic drugs.

Adverse Effects

Side effects of Ipratropium Bromide : Dry mouth, urinary retention, buccal ulceration, paralytic ileus, headache, nausea, constipation, paradoxical bronchospasm, immediate hypersensitivity reactions (urticaria, angioedema), acute angle-closure glaucoma. Potentially Fatal: Anaphylactic reactions, atrial fibrillation, supraventricular tachycardia.

Mechanism of Action

Ipratropium bromide blocks the action of acetylcholine at parasympathetic sites in bronchial smooth muscle causing bronchodilation.