ACP Ipratropium bromide
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- It blocks the muscarinic cholinergic receptors in the smooth muscles of the bronchi in the lungs
- - inhibiting bronchoconstriction and mucus secretion.
- - a non-selective muscarinic antagonist, and does not diffuse into the blood, which prevents systemic side-effects.
- - results from decreased concentrations of cyclic guanosine monophosphate (cyclic GMP).
- - Decreased levels of cyclic GMP produce local, not systemic, bronchodilation
- bronchospasm in asthma
- chronic bronchitis
Hypersensitivity to drug or atropine or its derivatives
- Duration: 4-6 hrs,
- Peak 1-2hrs
- Half life 2hrs
- 250 –500 mcg via nebulizer with Salbutamol (mixed)
- - repeat up to two times if necessary
- - Normally only 1-2 doses in other conditions (eg. emphysema, chronic bronchitis)
- Combivent: 2.5 – 5.0 ml nebule – repeat q 10 minutes prn (not to exceed max dose for Atrovent )
- MDI: minimum 1- 4 puffs prn; max 10
- - (give after salbutamol; ipratropium has a much slower onset of action)
- (ages 5-11)
- – 25-250 mcg via nebulizer with salbutamol (mixed) repeat up to times two if necessary
- MDI: minimum 2 puff prn; max 4 (give after salbutamol; ipratropium has a much slower onset of action)
- safety and efficacy in children under 12 years of age haven’t been established.
Nebulizer or metered dose inhaler
- Hypersensitivity to soy lecithin or related food products (soybeans, peanuts)
- Patients with narrow angle glaucoma
- Be careful to avoid accidental release into the eyes (use mouth piece neb if possible)
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