Ipratropium bromide begins to act on average after. Ipratropium bromide

Pharmacological group - m-cholinergics. The names of the drugs are Atrovent, Ipravent.

Composition and release form

Forms of release of the drug Ipratropium bromide

• Aerosol
• solution for inhalation

Composition of solution for inhalation Ipratropium bromide

• Active substance: 261 mcg ipratropium bromide monohydrate (calculated as ipratropium bromide 250 mcg).
• Excipients: benzalkonium chloride, disodium edetate dihydrate, sodium chloride, hydrochloric acid 1N, purified water.

pharmachologic effect

Reduces the secretion of bronchial mucus, blocks the activity of acetylcholine (a substance that causes contraction of the smooth muscles surrounding the airways), providing expansion of large and medium bronchi (bronchodilation).

Indications for use of Ipratropium bromide

To combat symptoms of lung diseases - asthma, chronic bronchitis and emphysema.

Contraindications

Hypersensitivity, pregnancy (1st trimester).

Limitations - angle-closure glaucoma, urinary disorders due to prostate hypertrophy. In the second and third trimesters and during breastfeeding, treatment is possible if the expected effect of therapy outweighs the potential risk to the fetus and child.

Side effects

Persistent constipation, lower abdominal pain, bloating, wheezing, difficulty breathing, chest tightness, severe eye pain, skin rashes or hives, swelling of the face, lips or eyelids. Call a doctor immediately. Possible dry mouth, cough, unpleasant taste. Rare - blurred vision, other vision changes, burning in the eyes, difficulty urinating, dizziness, headache, nausea, heavy heartbeat, nervousness, sweating, trembling.

Instructions for use

Method and dosage

Inhalation: 2 doses of aerosol (40 mcg) 4 r. per day (if necessary, up to 12 inhalations). Solution for inhalation: adults and children over 14 years of age: 0.1-0.5 mg 4 times a day through a nebulizer; children 6-14 years old - 0.1-0.25 mg 3-4 times a day through a nebulizer; children under 6 years old - 0.1-0.25 mg 3-4 times a day (under medical supervision).

Reception scheme

Start of action 5-15 minutes.

Duration of admission 3-4 hours.

If an appointment is missed Take the drug as soon as you remember it. If it is near the time of your next dose, skip the previous one and return to your regular schedule. Do not double the next dose.

Discontinuation Do not stop treatment without consulting your doctor

Overdose

There were no specific symptoms reported. An overdose is unlikely to be life-threatening, but if anyone takes a dose significantly higher than prescribed, or accidentally swallows the drug, contact your doctor immediately emergency care or the nearest poison control center.

special instructions

To check the inhaler, connect the canister to the mouthpiece, remove the cap from the mouthpiece, shake the inhaler 3-4 times and spray a little of the drug into the air. Clean your inhaler, mouthpiece, and spacer at least twice a week.

Precautionary measures

Over 60 years old No special problems are expected during treatment.

Driving a car and working with machinery Avoid these activities until you know how the medicine affects you.

Alcohol Instructions for use indicate that there is no need for special measures precautions.

Interaction with other drugs

Enhances the bronchodilator effect of beta-agonists and xanthine derivatives. There are no reports of food interaction.

Domestic and foreign analogues

Analogues of the drug can be drugs:

• Atrovent
• Atrovent N
• Ipravent
• Ipratropium Steri-Neb.

Price in pharmacies

The price of Ipratropium bromide in different pharmacies may vary significantly. This is due to the use of cheaper components and the pricing policy of the pharmacy chain.

Read the official information about the drug Ipratropium bromide, the instructions for use of which include general information and treatment plan. The text is provided for informational purposes only and cannot serve as a substitute for medical advice.

Indications for use

Chronic obstructive pulmonary disease (chronic obstructive bronchitis, emphysema), bronchial asthma (mild to moderate severity), especially with concomitant diseases of cardio-vascular system. hypersecretion of the bronchial glands, bronchospasm against the background colds, at surgical operations. tests for reversibility of bronchial obstruction. for the preparation of respiratory tract before the administration of aerosol antibiotics, mucolytic drugs, glucocorticoids, cromoglycic acid.

pharmachologic effect

Bronchodilator, m-anticholinergic
Blocks m-cholinergic receptors of the smooth muscles of the tracheobronchial tree. Having structural similarity to the acetylcholine molecule, it is its competitive antagonist. As a derivative of quaternary nitrogen, it is slightly soluble in fats and diffuses poorly through biological membranes. It has low bioavailability - inhalation of about 500 doses is necessary for the development of tachycardia (systemic effect). only 10% reaches the small bronchioles and alveoli, and the rest settles in the pharynx or oral cavity and is swallowed. It is practically not absorbed in the gastrointestinal tract and is excreted in feces. The absorbed portion (small) is metabolized into eight inactive or weakly active anticholinergic metabolites (excreted in the urine). The bronchodilator effect develops 5–10 minutes after inhalation and continues for 5–6 hours. It dilates mainly large and medium-sized bronchi, reduces the secretion of bronchial mucus.

Overdose

Symptoms: increased anticholinergic reactions (including dry mouth, impaired accommodation, increased heart rate). Treatment: symptomatic therapy.

(endo,syn)-(±)-3-(3-hydroxy-1-oxo-2-phenylpropoxy)-8-methyl-8-(1-methylethyl)-8-azoniabicyclo-octane bromide

Chemical properties

Ipratropium Bromide is a quaternary derivative that contains an isopropyl radical at the tropane heterocycle. The substance is poorly soluble in fats. Anticholinergic drug. Molecular weight = 332.5 grams per mole.

In the Russian Federation, medicine is included in the list of essential and vitally important medicines. medicines. Available in the form of an aerosol for inhalation, solution or capsules with powder for inhalation, coated tablets and solution for injection.

pharmachologic effect

M-anticholinergic, bronchodilator.

Pharmacodynamics and pharmacokinetics

The substance affects m-cholinergic receptors located in the smooth muscles of the tracheobronchial tree. Acts as a competitive antagonist. The product practically does not diffuse through biological membranes. After taking the drug, reflex bronchoconstriction decreases and the intensity of secretion of the glands located on the mucous membrane of the bronchi and nose decreases. The drug prevents the narrowing of the bronchi due to inhalation of cigarette smoke or cold air, eliminates bronchospasm, and neutralizes the effect of various bronchospasms.

The effect of the drug appears within 5-15 minutes after inhalation administration, reaching its maximum level within 60-120 minutes, lasting up to 8 hours. Under the influence of the substance, the heart rate increases, improves AV conduction . Mainly the medium and large bronchi expand.

Ipratropium Bromide has a low degree of systemic absorption. The medicine is excreted through the intestines, a quarter - unchanged, the rest - in the form of metabolites. The substance is not absorbed in the digestive tract and is excreted in the feces. Metabolism takes place in the liver. Does not have the ability to accumulate in the body. When taken orally, the drug has low bioavailability, after intramuscular injection Up to 90% of the product is absorbed.

Indications for use

The substance is prescribed in the form of inhalations for the treatment and prevention of:

• With emphysema or without;
• moderate and mild severity;
• bronchospasm during surgery.

Inhalation of Ipratropium Bromide is used to prepare the airways before administration antibiotics , GCS, mucolytic drugs and sodium cromoglycate .

Intranasally, the substance is prescribed for the treatment of chronic with excessive mucus secretion.

The medicine is used orally and intravenously:

• at sinus bradycardia associated with the action of the vagus nerve;
• for treatment bradyarrhythmias with sinoatrial block;
• at AV block second degree;
• in patients with atrial fibrillation (bradysystolic form).

Contraindications

The medicine is contraindicated for use during and during the first trimester.

Side effects

Ipratropium Bromide may cause:

• dryness in oral cavity and increased viscosity of sputum after inhalation;
• pupil dilation, height intraocular pressure with closed angle;
• allergic manifestations , dry mouth;
• irritation and dryness in the nose when used intranasally;
• constipation, anorexia , decreased activity of sweat glands;
• cough, nausea, edema due to allergies;
• rarely - extrasystolia , Pain in the eyes.

Ipratropium Bromide, instructions for use (Method and dosage)

Depending on the used dosage form and diseases apply different treatment regimens.

The drug is prescribed intranasally, in the form of inhalations, orally, intravenously and intramuscularly.

Overdose

In case of overdose they increase significantly anticholinergic reactions , the heart rate increases, accommodation is impaired, and dryness occurs in the mouth and nose.

Interaction

Combination with derivatives xanthine And beta-agonists may lead to increased bronchodilator effect.

Simultaneous use of the drug with anticholinergic drugs enhances the effect of their use.

Antiparkinsonian drugs, tricyclic antidepressants , enhance the effect of taking the medicine. facilities.

The drug is combined with caution due to the risk of increased intraocular pressure and development glaucoma .

special instructions

In patients cystic fibrosis When treated with this drug (oral intake), the risk of developing adverse reactions from the digestive system.

If the medication is ineffective or the patient’s condition worsens, it is recommended to consult a doctor to change the treatment regimen.

Caution is recommended when driving or performing other hazardous activities.

For children

During pregnancy and lactation

The drug is contraindicated for use in the first 3 months pregnancy . You can use the medicine in the 2nd and 3rd trimester and during lactation strictly on the recommendation of a doctor.

Drugs containing (Ipratropium Bromide analogues)

Analogues: , Ipratropium Steri-Neb , Ipratropium-native , Atrovent N , Ipravent .

The combination of Ipratropium Bromide + is included in the following drugs: Ipraterol-native , Fenipra , Ipraterol-aeronativ , Berodual N .

In combination with the substance found in the preparation Combivent And Ipramol Steri-Neb .

Ipratropium bromide + – active ingredients of drugs Otrivin Complex And .

(Ipratropium bromide)

Trade names

Arutropid, Atrovent, Vagos, Ipravent, Itrop.
Group affiliation

M-anticholinergic

Description active substance(INN)

Ipratropium bromide
Dosage form

dosed aerosol for inhalation, capsules with powder for inhalation, solution for inhalation
pharmachologic effect

A bronchodilator, it blocks m-cholinergic receptors of the smooth muscles of the tracheobronchial tree (mainly at the level of large and medium bronchi) and suppresses reflex bronchoconstriction, reduces the secretion of the glands of the nasal mucosa and bronchial glands. Having structural similarity to the acetylcholine molecule, it is its competitive antagonist. Effectively prevents the narrowing of the bronchi that occurs as a result of inhalation of cigarette smoke, cold air, the action of various bronchospasms, and also eliminates bronchospasm associated with the influence of n.vagus. When used in inhalation, it has virtually no resorptive effect - for the development of tachycardia, about 500 doses must be inhaled, while only 10% reaches the small bronchi and alveoli, and the rest settles in the pharynx or oral cavity and is swallowed. The bronchodilator effect develops after 5-15 minutes, reaches a maximum after 1-2 hours and lasts up to 6 hours (sometimes up to 8 hours).
Indications

COPD (with or without emphysema), bronchial asthma (mild to moderate severity), especially with concomitant cardiovascular diseases. Bronchospasm during surgical operations, against the background of colds. Tests for reversibility of bronchial obstruction; for preparing the respiratory tract before the administration of aerosols of antibiotics, mucolytic drugs, corticosteroids, cromoglycic acid.
Contraindications

Hypersensitivity, pregnancy (1st trimester). With caution. Angle-closure glaucoma, urinary tract obstruction (prostatic hyperplasia), childhood(up to 6 years - aerosol for inhalation, up to 5 years - solution for inhalation).
Side effects

Dry mouth, headache, nausea, increased viscosity of sputum. Rarely - tachycardia, palpitations, accommodation paresis, weakened gastrointestinal motility, constipation, urinary retention, cough, paradoxical development of bronchospasm. In case of contact with the eyes - mydriasis, accommodation paresis, increased intraocular pressure (in patients with angle-closure glaucoma), pain in the eye. Allergic reactions- skin rash (including urticaria and erythema multiforme), swelling of the tongue, lips and face, laryngospasm and other manifestations of anaphylaxis. When using an intranasal aerosol - dryness and irritation of the nasal mucosa, allergic reactions. Overdose. Symptoms: increased anticholinergic reactions. Treatment: symptomatic.
Dosage and administration

Metered aerosol: adults and children over 6 years of age - for the prevention of respiratory failure in COPD and bronchial asthma- 0.4-0.6 mg (2-3 doses) several times a day (on average 3 times), for treatment - additional inhalations of 2-3 doses of aerosol can be performed. Children under 12 years of age in the treatment of asthma (as an auxiliary therapy) - 18-36 mcg (1-2 inhalations), if necessary, every 6-8 hours. Solution for inhalation: adults for bronchitis, emphysema, COPD - 250-500 mcg 3 -4 times a day (every 6-8 hours); for asthma - 500 mcg 3-4 times a day (every 6-8 hours). Children from 5 to 12 years old - 125-250 mcg as needed 3-4 times a day.
special instructions

Enhances the bronchodilator effect of beta-agonists and xanthine derivatives (theophylline). The anticholinergic effect is enhanced by antiparkinsonian drugs, quinidine, and tricyclic antidepressants. When used simultaneously with other anticholinergic drugs, an additive effect occurs.