NAME Ipatropium bromide Apo-Ipravent, Atrovent, Atrovent HFA, Genipatropium (CAN)

CLASSIFICATION Anticholinergic Antimuscarinic Bronchodilator Parasympatholytic

CONTRAINDICATION Contraindicated with hypersentivity to atropine, or its derivatives, soybean or peanut allergies (aerosol).

INDICATION Bronchodilator for maintenance treatment of bronchospasm associated with COPD (solution aerosol), chronic bronchitis,a nd emphysema. Nasal spray: Symptomatic relief of rhinorrhea Associated with perennial rhinitis, common cold, seasonal allergic rhinitis.

ADVERSE EFFECT CNS: nervousness, dizziness, headache, fatigue, insomnia, blurred vision GI: diarrhea, nausea, dry mouth RESPIRATORY: dyspnea, bronchitis, bronchospasm, URI, cough, exacerbation of symptoms, hoarseness, pharyngitis. OTHER: back pain, chest pain, allergic-type reactions, palpitations, rash.

NURSING RESPONSIBILITIES Protect solution for inhalation from light. Store unused vials in foil pouch. Use nebulizer mouthpiece instead of face mask to avoid blurred vision or aggravation of narrowangle Glucoma. Can mix with albuterol nebulizer for up to 1 hr. Ensure adequate hydration; control environment (temperature) to prevent hyperexia. Have patient void after taking medication to avoid urinary retention Teach the patient the proper use of inhaler.

Use cautiously with narrow angle glaucoma, prostatic hypertrophy, bladder neck obstruction, pregnancy, lactation.