Ipratropium

General

• Type: Anticholinergic Agent
• Dosage Forms: Oral inhalation
• Common Trade Names: Atrovent

Adult Dosing

Asthma: 0.5mg Nebulized q20min, up to 3 doses
COPD: 0.5mg Nebulized q20mins, up to 3 doses

Pediatric Dosing

Asthma

• Children ≤5 years: 0.25mg Neb q20mins, up to 3 doses
• Children ≤12 years: 0.25-0.5mg Neb q20mins, up to 3 doses
• Children >12 years: Refer to adult dosing

Special Populations

• Pregnancy Rating: B
• Lactation risk categories: L3
• Renal Dosing - none
• Hepatic Dosing - none

Contraindications

• Allergy to anticholenergics (Atropine, Ipatropium)
• Not to be used as sole rescue agent in acute exacerbation

Adverse Reactions

Serious

• Death

Common

• Urinary retention
• Increased intraocular pressure
• Bitter taste in mouth
• Dry throat/Cough
• Nasal dryness

Pharmacology

• Half-life: 2-5hrs
• Metabolism: Possible ester hydrolysis
• Excretion: Fecal and Renal
• Mechanism of Action: Cholinergic antagonist of acetylcholine at the cholinergic receptors, causing dilatation of bronchial smooth muscle and decreased serous and seromucous glands secretion.

Indications by Condition

The following table is automatically generated from disease/condition pages across WikEM.

Indication	Dose	Context	Route	Population
Acute asthma exacerbation	0.25-0.5 mg nebulized q20min x2-3 doses	Anticholinergic adjunct (acute setting only)	Nebulized	Adult
Acute asthma exacerbation (peds)	0.25-0.5mg q20min x3 (with first 3 albuterol doses)	Adjunctive anticholinergic; reduces admissions	Nebulized	Pediatric