Pharm

Short-acting Anticholinergic Bronchodilator

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Short-acting Anticholinergic Bronchodilator, Ipratropium, Ipratropium Bromide, Atrovent, Combivent, Combivent Respimat

  • Mechanism
  1. Short-acting Anticholinergic Bronchodilator
  • Preparations
  • Ipratropium Bromide
  1. Atrovent MDI: 2-3 puffs three to four times daily
  2. Atrovent Nebulization: 1 ampule in nebulization solution every 6 hours prn
  • Preparations
  • Combination Ipratropium with Albuterol (Combivent)
  1. Combivent (older CFC version)
    1. Will be phased out in 2013 due to CFC
    2. Dose: 2 puffs up to every 6 hours
    3. Contraindicated in soybean or peanut allergy
  2. Combivent Respimat
    1. Dose: 1 puff every 6 hours
    2. Does not carry the Food Allergy related contraindications of the older Combivent
  • Adverse Effects
  1. Serious adverse effects
    1. Anaphylaxis, Angioedema or other Hypersensitivity Reaction
    2. Paradoxical bronchospasm or Laryngospasm
    3. Exacerbation of Glaucoma
    4. Increased cardiovascular events
      1. Avoid short acting Anticholinergics (Ipratropium) in comorbid cardiovascular disease
      2. Ogale (2010) Chest 137(1): 13-19 [PubMed]
      3. Singh (2008) JAMA 300(12): 1439-50 [PubMed]
  2. Common adverse effects
    1. Cough
    2. Dry Mouth or oral irritation
    3. Gastrointestinal upset such as Nausea
    4. Urticaria or other rash
    5. Headache
    6. Nervous sensation