Ipratropium is a synthetic derivative of the alkaloid atropine with anticholinergic properties. Ipratropium antagonizes the actions of acetylcholine at parasympathetic postganglionic effector cell junctions. When inhaled, ipratropium binds competitively to cholinergic receptors in the bronchial smooth muscle thereby blocking the bronchoconstrictor actions of the acetylcholine (Ach) mediated vagal impulses. Inhibition of the vagal tone leads to dilation of the large central airways resulting in bronchodilation.
Ipratropium bromide is a bronchodilator that dilates (enlarges) airways (bronchi) in the lungs. It is used in treating, symptoms of asthma, colds, allergies, and chronic obstructive pulmonary disease (COPD) due to emphysema or chronic bronchitis. Ipratropium blocks the effect of acetylcholine on airways (bronchi) and nasal passages. Acetylcholine is a chemical that nerves use to communicate with muscle cells.
Ipratropium is a synthetic anticholinergic agent that is used as an inhalant for treatment of acute bronchospasm due to chronic bronchitis and emphysema. Ipratropium has not been implicated in causing liver enzyme elevations or clinically apparent acute liver injury.
Mechanism of Action of Ipratropium
Ipratropium bromide is an anticholinergic agent. It blocks muscarinic cholinergic receptors, without specificity for subtypes, resulting in a decrease in the formation of cyclic guanosine monophosphate (cGMP). Most likely due to actions of cGMP on intracellular calcium, this results in decreased contractility of smooth muscle.
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Ipratropium is a synthetic derivative of the alkaloid atropine with anticholinergic properties. Ipratropium antagonizes the actions of acetylcholine at parasympathetic postganglionic effector cell junctions. When inhaled, ipratropium binds competitively to cholinergic receptors in the bronchial smooth muscle thereby blocking the bronchoconstrictor actions of the acetylcholine (Ach) mediated vagal impulses. Inhibition of the vagal tone leads to dilation of the large central airways resulting in bronchodilation.
Indications of Ipratropium
- Asthma Bronchial
- Asthma
- Bronchiectasis
- COPD, Maintenance
- Chronic Obstructive Pulmonary Disease (COPD)
- Rhinorrhea
- Chronic bronchitis and emphysema.
Contra-Indications of Ipratropium
- closed angle glaucoma
- Blockage of Urinary Bladder
- Enlarged Prostate
- Cannot Empty Bladder
Allergies
- Anticholinergics – Quaternary
- Ipratropium Analogues
Dosage of Ipratropium
Strengths: 500 mcg/2.5 mL; 18 mcg/inh; 17 mcg/inh
Chronic Obstructive Pulmonary Disease
- Inhalation aerosol: 2 inhalations (34 mcg) orally four times a day, or as needed up to 12 inhalations in 24 hours
- Nebulizer inhalation solution: 500 mcg three or four times a day by oral nebulization, with doses 6 to 8 hours apart.
Pediatric Chronic Obstructive Pulmonary Disease
Nebulizer inhalation solution
- Less than 12 years: Safety has not been established.
- 12 years or older: 500 mcg three or four times a day by oral nebulization, with doses 6 to 8 hours apart.
Side Effects of Ipratropium
The most common
- Shakiness in the legs, arms, hands, or feet
- trembling or shaking of the hands or feet
- stomach pain or cramping
- diarrhea
- a headache
- dizziness
- confusion
- stomach pain;
- back pain, joint or muscle pain.
- problems with your vision (including color vision);
- sudden chest pain or trouble breathing;
- pain or swelling in one or both legs;
- a pain, nausea, or light sensitivity. সহজ বাংলা: বারবার হওয়া বিশেষ ধরনের মাথাব্যথা।" data-rx-term="migraine" data-rx-definition="Migraine is a recurring headache disorder often with throbbing pain, nausea, or light sensitivity. সহজ বাংলা: বারবার হওয়া বিশেষ ধরনের মাথাব্যথা।">migraine headache;
- pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating; or
- feeling like you might pass out.
More common
- Abdominal or stomach pain, discomfort, or pain when an area is touched or pressed. সহজ বাংলা: চাপ দিলে ব্যথা।" data-rx-term="tenderness" data-rx-definition="Tenderness means pain when an area is touched or pressed. সহজ বাংলা: চাপ দিলে ব্যথা।">tenderness
- chills or fever
- difficulty with moving
- a headache, severe and throbbing
- joint or pain: Back pain means pain in the spine, muscles, discs, joints, or nerves of the back. সহজ বাংলা: পিঠ/কোমরের ব্যথা।" data-rx-term="back pain" data-rx-definition="Back pain means pain in the spine, muscles, discs, joints, or nerves of the back. সহজ বাংলা: পিঠ/কোমরের ব্যথা।">back pain
- muscle aching or cramping
- muscle pains or stiffness
- chest pressure or squeezing pain in the chest
- discomfort in arms, shoulders, neck or upper back
- excessive sweating
- feeling of heaviness, pain, warmth and/or swelling in a leg or in the pelvis
- sudden tingling or coldness in an arm or leg
- sudden slow or difficult speech
- sudden drowsiness or need to sleep
- fast breathing
- sharp pain when taking a deep breath
- fast or slow heartbeat
- coughing up blood
- rust colored urine
- decreased amount of urine
Rare
- Anxiety
- change in vision
- chest pain or tightness
- confusion
- a cough
- Agitation
- arm, back, or jaw pain
- blurred vision
- chest pain or discomfort
- convulsions
- extra heartbeats
- fainting
- hallucinations
- a headache
- irritability
- lightheadedness
- mood or mental changes
- muscle pain or cramps
- muscle spasm or jerking of all extremities
- nervousness
Drug Interactions of Ipratropium
Ipratropium bromide may interact with the following drugs, supplements & may change the efficacy of drugs
- antidepressants such as amitriptyline amoxapine; clomipramine, desipramine, doxepin, imipramine, nortriptyline, protriptyline, and trimipramine
- beta blockers such as atenolol, labetalol, metoprolol, nadolol, and propranolol
- diuretics
- epinephrine
- medications for colds, irritable bowel disease, Parkinson’s disease, ulcers, or urinary problems
- monoamine oxidase inhibitors such as isocarboxazid, phenelzine, tranylcypromine
- other inhaled medications, especially other medications for asthma such as arformoterol, formoterol, metaproterenol, levalbuterol, and salmeterol
- terbutaline
Pregnancy Catagory of Ipratropium
FDA Pregnancy Category B
Pregnancy
This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while using this medication, contact your doctor immediately.
Lactation
It is not known if ipratropium nasal spray passes into breast milk. If you are a breast-feeding mother and are using this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.The safety and effectiveness of using this medication have not been established for children under 12 years of age.
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