[1 nebule 26 cents]
- INH, NEB
- Atrovent, Combivent (ipratropium + salbutamol), Duolin (ipratropium + salbutamol)
PRESENTATION AND ADMINISTRATION:
Atrovent inhaler 20mcg/dose
Combivent inhaler 20mcg atrovent per dose and 100mcg salbutamol per dose
Ipratropium steri-neb 500mcg/2ml
Duolin 500mcg ipratropium and salbutamol 2.5mg per 2.5ml
2 puffs 4 times per day or, if ventilated, 5 puffs via metered dose inhaler adaptor into ventilator circuit
1 ampoule of Ipratropium or Duolin four times a day
DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:
- Dose as in normal renal function
DOSAGE IN PAEDIATRICS:
0.25-1ml of 250mcg/ml solution diluted to 4ml. In a severe attack administer every 20 minutes for 3 doses then administer 4 to 6 hourly after that.
- Ipratropium bromide is an anticholinergic (parasympatholytic) agent. Anticholinergics prevent the increases in intracellular concentration of cyclic guanosine monophosphate (cyclic GMP) which are caused by interaction of acetylcholine with the muscarinic receptor on bronchial smooth muscle.
- hypersensitivity to ipratropium bromide
- hypersensitivity to atropine or its derivatives.
- Immediate hypersensitivity reactions may occur after administration of ipratropium bromide, as demonstrated by rare cases of urticaria, angioedema, rash, bronchospasm, anaphylaxis and oropharyngeal edema. Inhaled medicines, including ipratropium bromide, may cause paradoxical bronchospasm. If this occurs, treatment with ipratropium bromide aerosol should be stopped and other treatments
Ipratropium should be used with caution in patients with narrow-angle glaucoma, prostatic hypertrophy or bladder-neck obstruction.
- Laboratory Tests: No tests in addition to routine ICU tests are required.
- Drug/Laboratory Test Interactions: None noted.
IMPORTANT DRUG INTERACTIONS FOR THE ICU
- None of note.
- Body as a Whole:
Back pain, headache
- Central and Peripheral Nervous System:
- GI System:
Dyspepsia, mouth dry, nausea
- Respiratory System:
Coughing, dyspnoea, rhinitis, sinusitis
- Urinary System:
Urinary tract infection