Ipratropium bromide (Atrovent®)

Adult Dose:

• Standing order - 0.5 mg mixed with 2.5 mg albuterol given via nebulizer over 5-15 minutes if the patient is not improving after a single albuterol-only nebulized treatment.
  
• A second 0.5 mg dose mixed with 2.5 mg albuterol may be given standing order, if needed.
  
• May be mixed with each of the three albuterol doses for status asthmaticus
  
• BioTel must authorize any additional doses.

If less than 1 year old, standing order

• 0.25 mg mixed with 2.5 mg albuterol given via nebulizer over 5 - 15 minutes if the patient is not improving after a single albuterol-only nebulized treatment.
  
• Medics may administer a second and third dose of 0.25 mg ipratropium mixed with 2.5 mg albuterol.
  
• If status asthmaticus is present, medics may combine ipratropium and albuterol for all three doses.
  

If 1 year or older, standing order

• 0.5 mg mixed with 2.5 mg albuterol given via nebulizer over 5 - 15 minutes if the patient is not improving after a single albuterol-only nebulized treatment.
  
• Medics may administer a second and third dose of 0.5 mg ipratropium mixed with 2.5 mg albuterol.
  
• If status asthmatic is present, medics may combine ipratropium and albuterol for all three doses

• Bronchodilation
  
• Dries respiratory tract secretions

• Bronchospasm associated with asthma or COPD that does not respond to the first dose of albuterol
  
• Bronchospasm from chemical toxins: nerve agents, cyanide, blistering agents, choking agents

• Tachycardia/Palpitations
  
• Restlessness/Nervousness
  
• Blurred vision
  
• Dizziness, Headache

• Dry mouth
  
• Cough, worsening of symptoms
  
• Skin rash

• Sensitivity to soy lecithin products (soybeans, peanuts)
  
• Sensitivity to Atropine
  
• Bronchoconstriction that is caused by allergic reaction