Ipratropium
Abstract
In this column, Sharon Rees aims to refresh knowledge and interest in some of the commonly used drugs in a series of tweets. This month she is talking about #ipratropium
Dr Sharon Rees @reesprescribe
Day 1: A derivative of atropine, #ipratropium bromide was discovered in 1976. Found to be a suitable inhalant for bronchospasm (later for rhinitis) as the topical anti-muscarinic action relaxed airways, with minimal systemic absorption. The main UK use is for maintenance of chronic obstructive pulmonary disease (COPD).
Dr Sharon Rees @reesprescribe
Day 2: #ipratropium used age > 1 month for acute airways obstruction, acute bronchospasm and severe asthma (nebulised solution). Adults (COPD) aerosol inhaler 20-40 mcg x3-4/day. Action starts at 15 mins, peaks at 30-60 mins, effect duration 3-6 hours. Nasal spray age >12 yrs for allergic/non-allergic rhinitis.
Dr Sharon Rees @reesprescribe
Day 2 (cont): #ipratropium can also be combined with short-acting beta2 agonists as nebulised solution for COPD bronchospasm.
Dr Sharon Rees @reesprescribe
Day 3: Kinetics; most of the inhaled dose is swallowed with ~10-20% entering lungs. Poor absorption across gut wall means minimal systemic exposure, but some circulating drug is absorbed via lungs.
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