Ipratropium Bromide Atrovent



BRAND NAME: Atrovent

CLASS: anticholinergic, bronchodilator

Mechanism of Action:

Anticholinergic (parasympatholytic) agent appears to inhibit vagally-mediated reflexes by antagonizing the action of acetylcholine, the transmitter released from the vagal nerve. (SEE: Notes)

Indications and Field use:

Treatment of bronchospasm associated with chronic obstructive pulmonary disease (emphysema and chronic bronchitis). To be used either alone or in combination with other bronchodilators especially beta adrenergics (i.e., albuterol).


Ipratropium bromide is contraindicated in known or suspected cases of hypersensitivity to ipratropium bromide or to atropine and its derivatives. Precaution: should be used with caution in patients with narrow angle glaucoma.

Adverse Reactions:

Resp: Coughing. Sputum increased CNS: Dizziness. Insomnia. Tremor. Nervousness

GI: Nausea


Incompatibilities/Drug Interactions:

None. Ipratropium bromide has been shown to be safe and effective bronchodilator when used in conjunction with beta adrenergic bronchodilators (albuterol).

Adult Dosage:

Give 500 mcg in 2.5 ml normal saline (1 unit dose vial) via SVN with a mouth piece or in-line with a ventilatory device. Repeat according to medical control preference. May mix one unit dose vial of ipratropium with one unit dose vial of albuterol.

Routes of Administration:

Nebulized, mouth piece or in-line Inhaler (patient's own)

Onset of Action:

5-15 minutes

Peak Effects:

60-120 minutes

Duration of Action:

240-480 minutes

Dosage Forms/Packaging:

Inhalation Solution Unit Dose Vial is supplied as a 0.02% clear, colorless solution containing 2.5 ml with 25 vials per foil pouch

Arizona Drug Box Supply Range:

Paramedics: 2 - 4 unit doses Intermediates: 2 - 4 unit doses Special Notes:

> Anticholinergics produce preferential dilatation of the larger central airways, in contrast to beta agonists, which affect the peripheral airways. May be more effective used in combination with beta agonists.

> Should be kept out of light in foil pouch and avoid excessive humidity. 

© Matt Dillard 2012