Ipratropium Bromide (Atrovent®)

Indications:

• 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\

Contraindications:

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

Precautions: Notify BioTel (prior to administration) if the patient has: Narrow-angle glaucoma, prostatic hypertrophy (enlarged prostate), bladder-neck obstruction

Side Effects:

• Tachycardia/Palpitations
• Restlessness/Nervousness
• Blurred vision
• Dizziness, Headache
• Dry mouth
• Cough, worsening of symptoms
• Skin rash
  

Adult Dose:

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

Pediatric Dose:

Standing order:
Bronchospasm refractory to a single nebulized albuterol in a pediatric patient at least 2 years of age or any age pediatric patient with a history of asthma:

• 0.5 mg mixed with 2.5 mg albuterol via nebulizer
• 0.25 mg for infants under 1 year of age
• May repeat up to 2 more times, combined with albuterol (total maximum number of doses: 3).

Status asthmaticus: may be combined with albuterol for all 3 initial nebulizer treatments.

Route: Inhalation

Drug Action:

• Bronchodilation
• Dries respiratory tract secretions

Class: Topical Anticholinergic/Parasympatholytic

Onset: 5-15 minutes

Duration: 4 - 6 hours