IPRATROPIUM
Drugs in Pregnancy and Lactation.
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Name: IPRATROPIUM
Class: Parasympatholytic
Risk Factor: BM
Fetal Risk Summary
Ipratropium, an anticholinergic compound chemically related to atropine, is a quaternary ammonium bromide used as a bronchodilator for the treatment of bronchospasm. Its use during pregnancy is primarily confined to patients with severe asthma (1).
Ipratropium was not teratogenic in mice, rats, and rabbits when administered either orally or by inhalation (2). Oral doses used in the reproductive toxicity studies were 2,000, 200,000, and 26,000 times the maximum recommended human daily dose [MRHDD], respectively. Doses used by inhalation in rats and rabbits were, respectively, 312 and 375 times the MRHDD. Schardein cited a German study that found no evidence of teratogenicity in mice, rats, and rabbits (3). A Japanese study involving rats and rabbits that found no adverse fetal effects except a slight weight reduction was described by Shepard (4).
Data from a surveillance study of Medicaid patients between 1982–1994 indicated that 37 women took this drug during the 1st trimester (F. Rosa, personal communication, FDA, 1996). One malformation, a renal obstruction, was observed. Preliminary analysis found no brain defects among 80 recipients following exposure anytime during pregnancy.
A 1991 brief report described the use of nebulized ipratropium, among other drugs, in the treatment of life-threatening status asthmaticus in a pregnant patient at 12.5 weeks' gestation (5). She eventually delivered a term 3440-g male infant (information on the condition of the newborn was not provided).
A number of sources recommend the use of inhaled ipratropium for severe asthma, especially in those not responding adequately to other therapy (1,6,7 and 8). The consensus appears to be that although human data are rare, there is no evidence that the drug is hazardous to the fetus. Moreover, it produces less systemic effects than atropine (1), and may have an additive bronchodilatory effect to b2 agonists (6).
Breast Feeding Summary
No reports describing the excretion of ipratropium into human milk have been located. A chemically related drug, atropine, is considered compatible with breast feeding by the American Academy of Pediatrics (9), although definitive data on the appearance of atropine in milk has not been published. Ipratropium is lipid-insoluble and, similar to other quaternary ammonium bases, may appear in milk. The amounts, although unknown, are probably clinically insignificant, however, especially after inhalation.
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References
- Report of the Working Group on Asthma and Pregnancy. Management of asthma during pregnancy. Washington, DC:National Institutes of Health Publication No. 93–3279, Public Health Service, US Department of Health and Human Services, 1993:20.
- Product information. Atrovent. Boehringer Ingelheim Pharmaceuticals, 1996.
- Schardein JL. Chemically Induced Birth Defects. 2nd ed. New York, NY:Marcel Dekker, 1993:343.
- Shepard TH. Catalog of Teratogenic Agents. 8th ed. Baltimore, MD:Johns Hopkins University Press, 1995:238.
- Gilchrist DM, Friedman JM, Werker D. Life-threatening status asthmaticus at 12.5 weeks' gestation. Chest 1991;100:285–6.
- D'Alonzo GE. The pregnant asthmatic patient. Semin Perinatol 1990;14:119–29.
- Schatz M. Asthma during pregnancy:interrelationships and management. Ann Allergy 1992;68:123–33.
- Moore-Gillon J. Asthma in pregnancy. Br J Obstet Gynaecol 1994;101:658–60.
- Committee on Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 1994;93:137–50.
Q&A about Ipratropium
can you use a steroid nasal spray in the same 24 hours period as ipratropium bromide?
this is for severe sinusitis
this is for severe sinusitis
Absolutely.
Are you taking ipratropium bromide by itself?
http://www.copdmadesimple.com
http://www.breathebetter.blogspot.com
Are you taking ipratropium bromide by itself?
http://www.copdmadesimple.com
http://www.breathebetter.blogspot.com
how is the mechanism of action of ipratropium?
and so the contraindications... somebody please help me....
and so the contraindications... somebody please help me....
Ipratropium solution administered either alone or with a beta-adrenergic stimulant solution is indicated as a bronchodilator for the maintenance treatment of bronchospasm associated with, or for the therapy of acute exacerbations of chronic obstructive pulmonary disease, including chronic bronchitis and emphysema. Ipratropium solution, when used in conjunction with a beta-adrenergic stimulant solution such as fenoterol or salbutamol, is indicated for acute asthmatic attacks. It is to be administered by compressed air or oxygen-driven nebulizers.
Contraindications: Known hypersensitivity to ipratropium, to any of the product's ingredients or to atropinics.
Contraindications: Known hypersensitivity to ipratropium, to any of the product's ingredients or to atropinics.
how can I get rid ot the tremors caused by ipratropium bromide and albuterol sulfate inhalation treatments?
Tremors are the most common side effect with these meds. The tremors will pass is due time, its patient specific. Some people experience it for just a few minutes and some have them for hours. I don't know of any way to reverse them, but I do promise that they will eventually go away. If it is too bothersome for you see if your doctor will switch you to Xopenex it has fewer side effects.
Ipratropium general questions! Please help!?
Hello, I am doing this assignment and I cannot find ANY information pertaining to ipratropium. I need info on what plant it can be found in, a retail selling price, company that produces it, discovery of it (who where when) etc. Any help (especially about the plant part) would be greatly appreciated.
Hello, I am doing this assignment and I cannot find ANY information pertaining to ipratropium. I need info on what plant it can be found in, a retail selling price, company that produces it, discovery of it (who where when) etc. Any help (especially about the plant part) would be greatly appreciated.
It appears that ipratropium is synthetic, not from a plant.
"The medicinal properties of naturally occurring anticholinergic agents such as atropine, found in many plants in the tropics and temperate climates, have been recognized for centuries. There are reports from India dating from the 17th century that describe the use of Datura stramonium leaves for the treatment of asthma from the 17th century. This plant arrived in Europe by the 19th century via British colonialists and was used to treat a wide assortment of breathing disorders.5 The anticholinergic agents, such as atropine and scopolamine, are readily absorbed from the respiratory and GI tracts and have significant side effects. Newer synthesized agents, such as ipratropium bromide, oxitropium bromide, and tiotropium bromide, have similar but modified chemical structures compared with naturally occurring anticholinergics. "
Without a drug plan, an inhaler costs between $30-50 and is good for 200 doses.
The second link is to a company that makes the "Combivent" inhaler--a mixture of ipratropium and albuterol.
"The medicinal properties of naturally occurring anticholinergic agents such as atropine, found in many plants in the tropics and temperate climates, have been recognized for centuries. There are reports from India dating from the 17th century that describe the use of Datura stramonium leaves for the treatment of asthma from the 17th century. This plant arrived in Europe by the 19th century via British colonialists and was used to treat a wide assortment of breathing disorders.5 The anticholinergic agents, such as atropine and scopolamine, are readily absorbed from the respiratory and GI tracts and have significant side effects. Newer synthesized agents, such as ipratropium bromide, oxitropium bromide, and tiotropium bromide, have similar but modified chemical structures compared with naturally occurring anticholinergics. "
Without a drug plan, an inhaler costs between $30-50 and is good for 200 doses.
The second link is to a company that makes the "Combivent" inhaler--a mixture of ipratropium and albuterol.
What is Ipratropium Bromide?
Asthma drug
Asthma drug
Ipratropium Bromide is an anticholinergic used to prevent bronchospasm associated with chronic lung diseases. Can be prescribed for runny nose. Is related to atropine sulfate.
which one of these drugs can not be treated for asthma, Ipratropium, metoprolol, or zafirlukast.?
asthma treament drugs
asthma treament drugs
metoprolol
What are the various stages of emphyzema and what should the patient expect to experience?
I was diagnosed with severe COPD- emphyzema 7 yrs ago. I am now disabled and unable to work. Minimal exertion wipes me out requiring either using inhalers or oxygen. How advanced is my condition and what should I expect. my lung capasity is rated at 33% total. I use albuterol/ipratropium meds in my nebulizer, Advair 500/50 inhaler. I experience exterme rapid heart rate with any exertion
I was diagnosed with severe COPD- emphyzema 7 yrs ago. I am now disabled and unable to work. Minimal exertion wipes me out requiring either using inhalers or oxygen. How advanced is my condition and what should I expect. my lung capasity is rated at 33% total. I use albuterol/ipratropium meds in my nebulizer, Advair 500/50 inhaler. I experience exterme rapid heart rate with any exertion
Hi There
Not sure on the different stages, but here are some ideas on how to plan on getting healthier.
Natural Cures
Note: While all of the following therapies and self-care approaches can significantly relieve emphysema symptoms over time, they will be of little avail if you continue to smoke and/or be exposed to secondhand smoke.
Aromatherapy: Inhaling the steamed vapors of the essential oils of eucalyptus and pine can help relieve symptoms of emphysema, as can massaging the essential oils of cedarwood, eucalyptus, or peppermint into the chest once or twice each day.
Ayurvedic Medicine: To help ease emphysema symptoms, Ayurvedic physicians recommend boiling two to three cloves of raw, organic garlic in water. Once the cloves become tender, crush them, add to the water and drink the entire mixture in order to relief chest pain and ease breathing.
Diet: If you suffer from emphysema, you need to be screened for food allergies and sensitivities, and then avoid eating those foods you are allergic or sensitive to. In addition, avoid all sugar and sugar products, wheat and wheat byproducts, soy products, soft drinks, commercially processed foods, and all foods containing artificial ingredients, such as additives, colorings, flavorings, and preservatives (BHA, BHT, sodium nitrite, sulfites, saccharin, aspartame, and cyclamates, to name a few). Also minimize your intake of milk and dairy products, and coffee and other caffeine products, as well as red meat, salt, refined carbohydrates (white breads, pastries, commercial pastas), corn, chocolate, and unhealthy fats (hydrogenated or trans fats).
Drink plenty of pure, filtered water; at least eight ounces every two hours. For best results, add fresh squeezed lemon juice and a dash of cayenne pepper, making sure to brush your teeth afterwards so the acid from the citrus is not allowed to sit on the teeth. In addition, enjoy freshly made organic vegetable juices throughout the day, as well as hot broths and soups. Diluted organic pear juice can loosen up lung congestion. As part of your daily diet, emphasize organic, whole foods, especially plenty of fresh, raw organic fruits and vegetables, preferably soaked nuts and seeds, organic, free-range meats and poultry, and wild-caught fish. Garlic, cayenne pepper, chili peppers, horseradish, mustard, and onions should be eaten regularly, due to their powerful health benefits for the lungs and overall respiratory system. Organic, extra virgin olive oil should be used liberally. Organic grapes and fresh grape juice can be effective, as well.
Herbs: Useful herbs for managing emphysema symptoms include coltsfoot tea and thyme, both of which can help reduce the buildup of mucus and sputum in the lungs and respiratory tract. Peppermint tea can also be used for this purpose. Anise oil mixed with honey can be helpful when taken before each meal. Ephedra can help reduce coughing and bronchial spasms, while mullein can aid in eliminating fluid buildup in the lungs and fighting and preventing associated infection. Other useful herbs include comfrey, fennel seed, fenugreek, licorice root, red poppy flowers, rosehips, rosemary, slippery elm, violet, and white horehound.
Homeopathy: The homoepathic remedies Aspidosperma and Carbo vegetabilis can help to ease symptoms of emphysema.
Hydrotherapy: Hydrotherapy is the application of water, ice, steam and hot and cold temperatures to maintain and restore health. Treatments include full body immersion, steam baths, saunas, sitz baths, colonic irrigation and the application of hot and/or cold compresses. Hydrotherapy is effective for treating a wide range of conditions and can easily be used in the home as part of a self-care program. Many Naturopathic Physicians, Physical Therapists and Day Spas use Hydrotherapy as part of treatment. I suggest several at-home hydrotherapy treatments.
*Purified water is essential for any hydrotherapy treatment. The section Remedies for Treating Chlorinated Bath Water offers clear instructions and recommendations.
Juice Therapy: The following juice combinations can be helpful for relieving symptoms: Carrot, celery, potatoes, spinach, wheatgrass, watercress, and one clove of garlic; barley juice with a clove of squeezed garlic; and the combined juices of grape, orange, lemon, and black currant.
Improving Indoor Air Quality: Improving the quality of your indoor air, both at home and at work, is an essential self-care step for helping to treat and prevent respiratory conditions, including bronchitis. Healthy air is warm, free of pollutants and odors, has a relative humidity of between 35 to 60 percent, and is high in oxygen and negative ions (3,000 to 6,000 negative ions per cubic centimeter). Today’s technology makes it easy to ensure that your indoor air meets the above criteria. A negative ion generator can not only increase the oxygen and negative ion content of indoor air, but can also cleanse it of harmful animal dander, bacteria, dust, mold, pollen, and viruses. Moreover, negative ions help to soothe and repair damaged mucosa of the nasal, lung, and bronchial pathways. For best results, choose a self-regulating negative ion generator that emits at least one trillion negative ions per second.
You should also use a humidifier to keep your indoor air moist, especially during winter months, when air tends to be drier. Choose a warm mist unit. Adding plants to your home and work environments can also help keep air moist. Certain plants, such as chrysanthemums, philodendron, and spider plants, can also help to keep your air free of circulating dust and microorganisms, since they act as natural air filters.
Also be sure that your home and work environments are properly ventilated, and avoid the use of synthetic materials in your home and workplace, including plastics.
Lifestyle: Avoid exposure to secondhand smoke and excessively cold or dry air. Also make it a point to get plenty of good sleep each night, sleeping in an environment that is free of dust and contains warm, moist air.
Nutritional Supplements: Useful nutrients for emphysema include vitamin C, vitamin B6, vitamin B12, vitamin C, vitamin E, chlorophyll, coenzyme Q10 (CoQ10), folic acid, lecithin, and the amino acids L-cysteine, L-methionine, and L-glutathione, and
Stop Smoking: If you smoke, seek help in order to quit. (See Addictions for more information.)
Alternative Professional Care
The following therapies can also help to prevent and relieve emphysema: Acupressure, Acupuncture, Biofeedback Training and Neurotherapy, Bodywork (Reflexology, Rofling, Shiatsu), Chelation Therapy, Energy Medicine, Guided Imagery, Magnet Therapy, Mind/Body Medicine, Naturopathic Medicine, Osteopathic Medicine, Qigong, Tai Chi, Traditional Chinese Medicine, and Yoga.
Best of health to you
Cheers
Not sure on the different stages, but here are some ideas on how to plan on getting healthier.
Natural Cures
Note: While all of the following therapies and self-care approaches can significantly relieve emphysema symptoms over time, they will be of little avail if you continue to smoke and/or be exposed to secondhand smoke.
Aromatherapy: Inhaling the steamed vapors of the essential oils of eucalyptus and pine can help relieve symptoms of emphysema, as can massaging the essential oils of cedarwood, eucalyptus, or peppermint into the chest once or twice each day.
Ayurvedic Medicine: To help ease emphysema symptoms, Ayurvedic physicians recommend boiling two to three cloves of raw, organic garlic in water. Once the cloves become tender, crush them, add to the water and drink the entire mixture in order to relief chest pain and ease breathing.
Diet: If you suffer from emphysema, you need to be screened for food allergies and sensitivities, and then avoid eating those foods you are allergic or sensitive to. In addition, avoid all sugar and sugar products, wheat and wheat byproducts, soy products, soft drinks, commercially processed foods, and all foods containing artificial ingredients, such as additives, colorings, flavorings, and preservatives (BHA, BHT, sodium nitrite, sulfites, saccharin, aspartame, and cyclamates, to name a few). Also minimize your intake of milk and dairy products, and coffee and other caffeine products, as well as red meat, salt, refined carbohydrates (white breads, pastries, commercial pastas), corn, chocolate, and unhealthy fats (hydrogenated or trans fats).
Drink plenty of pure, filtered water; at least eight ounces every two hours. For best results, add fresh squeezed lemon juice and a dash of cayenne pepper, making sure to brush your teeth afterwards so the acid from the citrus is not allowed to sit on the teeth. In addition, enjoy freshly made organic vegetable juices throughout the day, as well as hot broths and soups. Diluted organic pear juice can loosen up lung congestion. As part of your daily diet, emphasize organic, whole foods, especially plenty of fresh, raw organic fruits and vegetables, preferably soaked nuts and seeds, organic, free-range meats and poultry, and wild-caught fish. Garlic, cayenne pepper, chili peppers, horseradish, mustard, and onions should be eaten regularly, due to their powerful health benefits for the lungs and overall respiratory system. Organic, extra virgin olive oil should be used liberally. Organic grapes and fresh grape juice can be effective, as well.
Herbs: Useful herbs for managing emphysema symptoms include coltsfoot tea and thyme, both of which can help reduce the buildup of mucus and sputum in the lungs and respiratory tract. Peppermint tea can also be used for this purpose. Anise oil mixed with honey can be helpful when taken before each meal. Ephedra can help reduce coughing and bronchial spasms, while mullein can aid in eliminating fluid buildup in the lungs and fighting and preventing associated infection. Other useful herbs include comfrey, fennel seed, fenugreek, licorice root, red poppy flowers, rosehips, rosemary, slippery elm, violet, and white horehound.
Homeopathy: The homoepathic remedies Aspidosperma and Carbo vegetabilis can help to ease symptoms of emphysema.
Hydrotherapy: Hydrotherapy is the application of water, ice, steam and hot and cold temperatures to maintain and restore health. Treatments include full body immersion, steam baths, saunas, sitz baths, colonic irrigation and the application of hot and/or cold compresses. Hydrotherapy is effective for treating a wide range of conditions and can easily be used in the home as part of a self-care program. Many Naturopathic Physicians, Physical Therapists and Day Spas use Hydrotherapy as part of treatment. I suggest several at-home hydrotherapy treatments.
*Purified water is essential for any hydrotherapy treatment. The section Remedies for Treating Chlorinated Bath Water offers clear instructions and recommendations.
Juice Therapy: The following juice combinations can be helpful for relieving symptoms: Carrot, celery, potatoes, spinach, wheatgrass, watercress, and one clove of garlic; barley juice with a clove of squeezed garlic; and the combined juices of grape, orange, lemon, and black currant.
Improving Indoor Air Quality: Improving the quality of your indoor air, both at home and at work, is an essential self-care step for helping to treat and prevent respiratory conditions, including bronchitis. Healthy air is warm, free of pollutants and odors, has a relative humidity of between 35 to 60 percent, and is high in oxygen and negative ions (3,000 to 6,000 negative ions per cubic centimeter). Today’s technology makes it easy to ensure that your indoor air meets the above criteria. A negative ion generator can not only increase the oxygen and negative ion content of indoor air, but can also cleanse it of harmful animal dander, bacteria, dust, mold, pollen, and viruses. Moreover, negative ions help to soothe and repair damaged mucosa of the nasal, lung, and bronchial pathways. For best results, choose a self-regulating negative ion generator that emits at least one trillion negative ions per second.
You should also use a humidifier to keep your indoor air moist, especially during winter months, when air tends to be drier. Choose a warm mist unit. Adding plants to your home and work environments can also help keep air moist. Certain plants, such as chrysanthemums, philodendron, and spider plants, can also help to keep your air free of circulating dust and microorganisms, since they act as natural air filters.
Also be sure that your home and work environments are properly ventilated, and avoid the use of synthetic materials in your home and workplace, including plastics.
Lifestyle: Avoid exposure to secondhand smoke and excessively cold or dry air. Also make it a point to get plenty of good sleep each night, sleeping in an environment that is free of dust and contains warm, moist air.
Nutritional Supplements: Useful nutrients for emphysema include vitamin C, vitamin B6, vitamin B12, vitamin C, vitamin E, chlorophyll, coenzyme Q10 (CoQ10), folic acid, lecithin, and the amino acids L-cysteine, L-methionine, and L-glutathione, and
Stop Smoking: If you smoke, seek help in order to quit. (See Addictions for more information.)
Alternative Professional Care
The following therapies can also help to prevent and relieve emphysema: Acupressure, Acupuncture, Biofeedback Training and Neurotherapy, Bodywork (Reflexology, Rofling, Shiatsu), Chelation Therapy, Energy Medicine, Guided Imagery, Magnet Therapy, Mind/Body Medicine, Naturopathic Medicine, Osteopathic Medicine, Qigong, Tai Chi, Traditional Chinese Medicine, and Yoga.
Best of health to you
Cheers
ipratropium bromide inhaler?
my doc has given my 9 month old daughter the above inhaler cos she has a cough and a cold. i'm reading up that it's for asthma sufferers and people with lung difficiencies. is there anything else i can give her as an alternative? cough medicines etc are not working but i'm a bit sceptial about giving her this at such a young age.
my doc has given my 9 month old daughter the above inhaler cos she has a cough and a cold. i'm reading up that it's for asthma sufferers and people with lung difficiencies. is there anything else i can give her as an alternative? cough medicines etc are not working but i'm a bit sceptial about giving her this at such a young age.
That is an extremely odd prescription .... the age doesn't concern me as much as why this particular drug was prescribed ....
This drug is known to have some antitussive effects ... but I am not sure how effective it is .... I surely haven't seen it used that way ... although it could be used ... and has generally no significant side effects ....
This drug is known to have some antitussive effects ... but I am not sure how effective it is .... I surely haven't seen it used that way ... although it could be used ... and has generally no significant side effects ....
Can Carvedilol be used in someone with COPD?
This is a case study.
The patient is a 62 y/o man complaining of decreased exercise tolerance. He suffered an MI 2 years ago for which he received PCI and a bare metal stent.. He has DM type II, COPD, and hyperlipidemia. Pertinent meds are verapamil ER 240mg daily, ISDN 30mg daily. He also takes NPH insulin for DM and albuterol and ipratropium for COPD. Also he is on aspirin 81mg daily.
His current ejection fraction is 30% and BP is 118/86. HR is 74 bpm, Scr is 1.4. BUN is 24 and Na and K are in normal limits.
I think the verapamil should be discontinued and replaced with carvedilol since it has been studied more in heart failure, but I'm worried about it affecting his COPD status. Can you tell me what suggestions you have? Please include references (or links) if you are using web resources.
Serious answers only please. Thank You!
This is a case study.
The patient is a 62 y/o man complaining of decreased exercise tolerance. He suffered an MI 2 years ago for which he received PCI and a bare metal stent.. He has DM type II, COPD, and hyperlipidemia. Pertinent meds are verapamil ER 240mg daily, ISDN 30mg daily. He also takes NPH insulin for DM and albuterol and ipratropium for COPD. Also he is on aspirin 81mg daily.
His current ejection fraction is 30% and BP is 118/86. HR is 74 bpm, Scr is 1.4. BUN is 24 and Na and K are in normal limits.
I think the verapamil should be discontinued and replaced with carvedilol since it has been studied more in heart failure, but I'm worried about it affecting his COPD status. Can you tell me what suggestions you have? Please include references (or links) if you are using web resources.
Serious answers only please. Thank You!
The correct answer seems to be yes and no.Coreg is contraindicated for asthma, however research indicates beta blockers do not have to be avoided in COPD patients.I would think Toprol xl would be the better choice to replace Verapamil.
Effects of lung inhalents on others?
I am currently using a nebulizer 3 times a day using a combination of Xopenex and Ipratropium Bromide. My wife says this stuff smells and bothers her sinus and eyes even though she may be in another room. She also says it smells. I of course don't smell anything nor does it bother me. Any one got any thoughts about this. By the way my wife has very sensitive sinus and graves disease (eye).
I am currently using a nebulizer 3 times a day using a combination of Xopenex and Ipratropium Bromide. My wife says this stuff smells and bothers her sinus and eyes even though she may be in another room. She also says it smells. I of course don't smell anything nor does it bother me. Any one got any thoughts about this. By the way my wife has very sensitive sinus and graves disease (eye).
I agree with the other contributor that you should speak to your doctor but not to switch to MDI's. If your doctor thought that you should be on them you would already be using them. If your wife is that sensitive to the exhaled medication from your nebulizer ask your doctor to work with your home care company to get you a nebulizer that has a filter so that what you exhale is blown out into the filter and not directly into the room air. We use this type in the hospital for certain medications when the patient may have TB. This should lessen the effect on your wife and therefore your marriage. Ipratropium can cause trouble for people with glucoma and graves disease. Hopefully the homecare company will be able to comply quickly. Best of luck to you.
