Ipratropium Bromide
 
Presentation
• 250mcg in 1ml nebule or polyamp
Pharmacology
• Anticholinergic bronchodilator
Actions
• Allows bronchodilatation by inhibiting cholinergic bronchomotor tone (i.e. blocks vagal refexes which mediate bronchoconstriction)
Metabolism
• Excreted by the kidneys
Primary Emergency Indications
• Severe respiratory distress associated with bronchospasm Adult Paed
Contraindications
• Known hypersensitivity to Atropine or its derivatives
Precautions
• Glaucoma
• Avoid contact with eyes
Route of Administration
• Nebulised in combination with Salbutamol
Side Effects
• Headache
• Nausea
• Dry mouth
• Skin Rash
• Tachycardia (rare)
• Palpitations (rare)
• Acute angle closure glaucoma secondary to direct eye contact (rare)
Special Notes
• There have been isolated reports of ocular complications (mydriasis, increased intraocular pressure, acute angle glaucoma, eye pain) as a result of direct eye contact of Ipratropium Bromide formulations
• The nebuliser mask must therefore be ftted properly during inhalation and care taken to avoid Ipratropium Bromide solution entering the eyes
• Ipratropium Bromide must be nebulised in conjunction with Salbutamol and is to be administered as a single dose only
Therapeutic Effect
Nebulised     
Onset:
3-5min
Peak:
90min-120min
Duration:
6hr