VOL: 101, ISSUE: 14, PAGE NO: 27
Generic and proprietary names
- Ipratropium bromide, Atrovent, Ipratropium, Ipratropium steri-neb, Respontin, Rinatec.
- Also in combination bronchodilator preparations such as Combivent and Duovent.
- Inhibits the interaction of acetylcholine at the bronchial smooth muscle receptor sites causing bronchodilation.
- Synthetic quaternary ammonium compound.
- Reversible airways obstruction, particularly in patients who have COPD.
- Allergic and non-allergic rhinitis.
- Hypersensitivity to previous administration.
- Prostatic hyperplasia.
- Pregnancy and breastfeeding.
- Bladder outflow obstruction.
- Dry mouth.
- Nasal spray can cause nasal dryness and epistaxis.
- Side-effects can be increased when used with any other antimuscarinic medication and with some antihistamines, antipsychotics, antidepressants and anti-arrhythmics. However, the reaction does not generally apply to inhalations.
- Aerosol inhaler.
- Powder inhaler.
- Nebuliser solution.
- Nasal spray.
- Check inhaler technique.
- Ensure that patients are able to correctly use the delivery device for their medication and consider use of a space if appropriate.
- If administering by nebulisers use a mouthpiece rather than face mask.
- If administered by nebuliser the dilution of the solution should be adjusted according to equipment and length of administration.
- Paradoxical bronchospasm has occurred with nebulised solution, therefore first dose should be used under medical supervision.
- Caution should be taken not to confuse Atrovent with Alupent.
- Evaluate therapeutic response.
- Advise patients not to exceed the prescribed dose.
- Rinse mouth after each use of the inhaler.
- Frequent drinks and the use of sugar-free gum can help with dry mouth.
- Seek medical attention if more than the usual dosage is required.
- Keep delivery devices clean and dry.
- Take a missed dose as soon as remembered unless it is almost time for the next dose. Do not take a double dose.
- Avoid getting in eyes.
Nurses should refer to manufacturer’s summary of product characteristics and to appropriate local guidelines