Ipratropium Bromide

Question 1

What are the presentations?

Answer 1

250mcg in 1ml nebule
Metered Dose Inhaler (MDI)
20mcg per puff

Question 2

What does it do?

Answer 2

An anticholinergic bronchodilator. It inhibits the vagal reflexes that mediate bronchospasm.
Combined with a nebulised beta-2 agonist (Salbutamol), Ipratropium bromide produces significantly greater bronchodilation than a beta-2 agonist alone.

Question 3

What are the indications?

Answer 3

Severe bronchospasm:

Adult: Severe to life-threatening asthma or COPD

Paediatric: Severe to life-threatening asthma

Question 4

What are the contraindications?

Answer 4

Hypersensitivity

Question 5

What are the precautions?

Answer 5

Glaucoma

Avoid contact with eyes.

Question 6

What is the adult dose?

Answer 6

Nebulised (combined with salbutamol):
500mcg in 2ml
Repeat nebulised dose every 20mins; maximum of 3 doses.
MDI:
12 puffs, 1 breath per puff
Administer once only.

Question 7

What is the dose for a child >6 years?

Answer 7

Nebulised: 500mcg in 2mL. Repeat every 20mins; maximum of 3 doses.
MDI: 8 puffs, 1 breath per puff Administer once only

Question 8

What is the dose for a child <6 years?

Answer 8

Nebulised: 250mcg in 1mL. Repeat every 20mins; maximum of 3 doses.
MDI: 4 puffs, 1 breath per puff. Administer once only

Question 9

What are the side effects?

Answer 9

Headache.
Nausea.
Dry Mouth.
Skin rash.