Atrovent Inhaler provides a bronchodilating agent. It blocks m-cholinergic receptors of the smooth muscle of the tracheobronchial tree and suppresses reflex bronchoconstriction. Having a structural similarity with the acetylcholine molecule, this drug is its competitive antagonist. Anticholinergics prevent an increase in the intracellular concentration of calcium ions, which occurs as a result of the acetylcholine interaction with muscarinic receptors located in the bronchial smooth muscles.
Indications for use
- Chronic obstructive pulmonary disease (including chronic obstructive bronchitis, pulmonary emphysema);
- Bronchial asthma (moderate and mild severity).
Contraindications
- Hypersensitivity to atropine and its derivatives;
- Hypersensitivity to ipratropium bromide or to other components of the drug.
- Possible severe reactions are in the cases of:
- angle-closure glaucoma;
- urinary tract obstruction;
- prostatic hyperplasia;
- breastfeeding;
- child age (up to 6 years).
Use during pregnancy and breastfeeding
The safety of Atrovent inhaler during pregnancy in humans has not been established. When prescribing a drug during a possible or confirmed pregnancy, consider the ratio of the possible benefits to the mother and the possible risk to the fetus.
In preclinical studies, no embryotoxic or teratogenic effects of the drug were detected after its inhalation use in doses significantly higher than the doses recommended in humans.
It is not known whether ipratropium bromide is excreted in breast milk. However, it is unlikely that ipratropium bromide, especially when it is administered by inhalation, can be delivered with milk to the baby’s body in substantial quantities. But during the use of this drug, breastfeeding mothers should be careful.
Clinical data on the effect of ipratropium bromide on fertility are not available. During the use of ipratropium bromide in preclinical studies, no adverse effect on fertility was found.
Dosage
Dosing regimen is selected individually.
Supportive treatment:
Adults (including the elderly) and children over 12 years old:
- 2.0 ml (40 drops = 0.5 mg) 3-4 times a day.
- The maximum daily dose is 8.0 ml (2 mg).
Children from 6 to 12 years:
- Treatment should be conducted under medical supervision;
- 1.0 ml each (20 drops = 0.25 mg) 3-4 times a day.
- The maximum daily dose is 4 ml (1 mg).
Children under 6 years:
- Treatment should be under medical supervision;
- 0.4 -1.0 ml (8-20 drops = 0.1-0.25 mg) 3-4 times a day.
- The maximum daily dose is 4 ml (1 mg).
Acute bronchospasm:
- Adults (including the elderly) and children over 12 years old: 2.0 ml (40 drops = 0.5 mg).
- Repeated appointments are possible until the patient’s condition is stabilized. The interval between inhalations is determined by the doctor.
- Atrovent can be used in conjunction with inhaled β2-adrenomimetics.
Children from 6 to 12 years:
- Treatment should be conducted under medical supervision in dosages of 1.0 ml (20 drops = 0.25 mg);
- Repeated appointments are possible until the patient’s condition is stabilized. The interval between inhalations is determined by the doctor.
- Atrovent inhaler can be used in conjunction with inhaled β2-adrenomimetics.
Children under 6 years:
Treatment should be under medical supervision in dosages of 0.4-1.0 ml (8-20 drops = 0.1- 0.25 mg).
Repeated appointments are possible until the patient’s condition is stabilized. The interval between inhalations is determined by the doctor. Atrovent can be used in conjunction with inhaled β2-adrenomimetics.
Side effects
- Immune system disorders: hypersensitivity, anaphylactic reaction.
- Nervous system disorders: headache, dizziness.
- Violations by the organ of vision: blurred vision, mydriasis, increase in intraocular pressure, glaucoma, pain in the eyes, the appearance of a halo around objects, conjunctival hyperemia, corneal edema, accommodation disturbances
- Heart disorders: heartbeat, supraventricular tachycardia, atrial fibrillation, increase in heart rate.
- Disorders of the respiratory system, chest and mediastinum: pharyngeal irritation, cough, bronchospasm, paradoxical bronchospasm, laryngismus, pharyngeal edema. dry throat.
- Disorders of the gastrointestinal tract: dry mouth, nausea, dysmotility of the gastrointestinal tract, diarrhea, constipation, vomiting, stomatitis, swelling of the mouth.
- Changes in the skin and subcutaneous tissues: rash, itch, edema, hives.
- Kidney and urinary tract disorders: urine retention.
If you buy Atrovent inhaler you should be ready for different side effects but they all have a temporary nature disappearing within time.
Overdose
Symptoms of specific overdose have been identified. Given the breadth of therapeutic action and the local way of using Atrovent inhaler, the appearance of any serious anticholinergic symptoms is unlikely. There may be minor manifestations of systemic anticholinergic effects, such as dry mouth, blurred vision, increased heart rate. Symptomatic treatment is prescribed.
Interactions with other drugs
Long-term combined use of Atrovent inhaler with other anticholinergic drugs has not been studied. Therefore, the long-term combined use of this drug with other anticholinergic drugs is not recommended.
Beta-adrenergic agents and xanthine derivatives can enhance the bronchodilator effect of the described drug.
In the case of simultaneous use with a nebulizer ipratropium bromide and beta adrenomimetics in patients with acute glaucoma in history, the risk of developing acute glaucoma may increase.
The solution for inhalation should not be administered simultaneously with inhalation solution of cromoglicic acid, given the possibility of precipitation.
The anticholinergic effect is enhanced by anti-Parkinsonian drugs, quinidine, tricyclic antidepressants.