Ipratropium Bromide (Atrovent) ๐
โ ๏ธ Ipratropium bromide can cause eye complications if aerosol/nebuliser mist reaches the eyes.
โก๏ธ Contact with the eye may cause a unilateral dilated pupil, eye pain, and can precipitate acute angle-closure glaucoma.
๐ About
Always check the BNF link here for full details.
- ๐จ Short-acting inhaled anticholinergic bronchodilator (SAMA).
- Used in both Asthma and COPD management, especially acute settings.
โ๏ธ Mechanism of Action
- Blocks muscarinic (M3) receptors in airway smooth muscle โ bronchodilation.
- Onset: 30โ60 minutes โฑ๏ธ.
- Duration: 3โ6 hours โ typically dosed every 6โ8 hours.
๐ฏ Indications & Dosing
- ๐ซ Chronic Asthma/COPD:
Ipratropium aerosol 20โ40 mcg every 6 hours (max 80 mcg q6h).
Onset 30โ60 min, lasts ~6 hours.
- ๐จ Acute Asthma / COPD Exacerbation:
Ipratropium Bromide (Atrovent) Nebulised 250โ500 mcg every 4โ6 hours.
โ ๏ธ Use with air in COPD (to avoid COโ retention).
โ ๏ธ Use with high-flow oxygen in acute asthma.
โ Cautions / Contraindications
- Glaucoma (risk of precipitating acute angle closure ๐๏ธ).
- Prostatic hypertrophy / urinary retention risk ๐ง.
- Care in patients with bladder outflow obstruction or arrhythmias.
โ ๏ธ Side Effects
- Blurred vision, dilated pupils, eye pain ๐๏ธ.
- Dry mouth, throat irritation, urinary retention.
- Flushing, tachycardia, palpitations โค๏ธ.
- Headache, constipation.
- Allergic reactions (skin rash, angioedema).
- Rare: paradoxical bronchospasm ๐ซ.
๐ References