Ipratropium Bromide: What Is It For?

Ipratropium bromide is indicated for the treatment of reversible bronchospasm associated with chronic obstructive pulmonary disease (COPD).
Ipratropium bromide: what is it for?

Ipratropium bromide is an active substance that belongs to the group of drugs called inhaled anticholinergic bronchodilators. It works by relaxing the bronchial muscles, facilitating the passage of air and, therefore, breathing.

It is indicated for the treatment of reversible bronchospasm associated with chronic obstructive pulmonary disease (COPD). Used in conjunction with inhaled beta 2 agonist drugs, it is useful in the treatment of chronic and acute asthma.

How does it work?

Hands with inhaler

Ipratropium bromide is a competitive antagonist of the muscarinic acetylcholine receptors. It has a powerful effect on bronchial receptors, both intravenously and by inhalation, but does not cause tachycardia. It also reverses bronchoconstriction induced by inhaled cholinergic agonists.

Ipratropium bromide: recommended doses

The dose must be tailored to individual needs and can be repeated until the patient is stable. The time interval between one administration and another is determined by the doctor.

It is recommended not to exceed the recommended doses, both in acute treatment and in maintenance. Ipratropium bromide can be combined with short-acting beta 2 adrenergic agonists in the same spray chamber. 

The solution must be used immediately after mixing and what is left must be discarded. The administration uses the different nebulizer devices available on the market.

Contraindications and warnings

Ipratropium bromide is contraindicated in case of allergy to the same or other similar substances, such as atropine and its derivatives. It should also not be administered in cases of acute coughing, wheezing and bronchospasm requiring a rapid response.

Caution should be exercised in the use of anticholinergic agents in patients with narrow-angle glaucoma, prostatic hyperplasia or bladder obstruction. In addition, special care should be taken in the case of patients with cystic fibrosis as they are more prone to gastrointestinal motility disorders.

Exceptionally, hypersensitivity reactions may occur soon after administration. These reactions include manifestations such as urticaria, angioedema, rash, bronchospasm, oropharyngeal edema and anaphylaxis.

If the aerosol is administered incorrectly and gets into the eye, ipratropium bromide can cause eye complications such as:

  • Mydriasis.
  • Increased intraocular pressure.
  • Narrow angle glaucoma.
  • Pain or discomfort in the eyes.
  • Blurred vision.

How do you use the ipratropium bromide inhaler?

If you are prescribed this drug, it is important that you learn how to take it correctly. Contact or spray of the solution into the eyes should be avoided. Each time you use your inhaler, follow these steps:

  • Remove the protective cap.
  • Breathe out deeply.
  • Grasp the inhaler and tightly squeeze the mouthpiece with your lips.
  • Inhale as much as you can and, at the same time, press the base of the bottle so that the solution is atomized.
  • Hold your breath for a few seconds, then release the mouthpiece and exhale slowly. When finished, close the protective cap.

Does it interact with other medications?

Hand with inhaler

Research shows that co-administration of ipratropium bromide with beta-adrenergic and xanthine derivatives may enhance the bronchodilator effect. However, this medicine can be given together with other drugs commonly used in the treatment of chronic obstructive pulmonary disease (COPD).

The risk of acute glaucoma in patients with a history of narrow-angle glaucoma is increased when co-administered with nebulised ipratropium bromide and beta-2-adrenergic agonists.

Ipratropium bromide: adverse reactions

Like all drugs, ipratropium bromide can cause side effects. The most frequent are: 

  • Headache.
  • Nausea.
  • Cough and throat irritation.
  • Vertigo.
  • Dry mouth
  • Disorders of gastrointestinal motility.

Other less frequent side effects such as hypersensitivity, severe allergic reaction, blurred vision, mydriasis, increased internal pressure of the eye, red eyes and eye pain may also occur.

Conclusions

Alone or associated with a beta-adrenergic, ipratropium bromide is used in the treatment of bronchospasm associated with viral bronchiolitis and bronchopulmonary dysplasia in infants and young children.

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