Name of Drug Classification
Generic Name:
Ipratropium
Trade/Brand Name:
Aerovent, Apovent
Atronase, Ipraxa, Ipvent
Rhinovent, Rinatec
Rinovagos, Atrovent,
Atrovent HFA
Patients’ Dose-----------
Route: Inhalation,
Intranasal
Form: Inhalation solution,
Nasal spray
Maximum dose:
Minimum dose:
Availability:
Aerosol inhaler (HFA)
(chlorofluorocarbonfree)
: Source:
17 mcg/spray in 12.9-g
canister (200 inhalations).
Inhalation solution:
0.0125%, 0.02% in
single-dose vials
containing 500 mcg,
0.025%.
Nasal spray: 0.03%
solution—21 mcg/spray in
30-mL bottle (345
sprays/bottle), 0.06%
solution—42 mcg/
spray in 15-mL bottle (165
sprays).
In combination with:
albuterol (Combivent,
Mechanism of Action
Pharmacologic Inhaln: Inhibits
Class: cholinergic receptors in
anticholinergics bronchial smooth muscle,
resulting in decreased
Therapeutic concentrations of cyclic
Class: guanosine monophosphate
allergy, cold, and (cGMP). Decreased levels
cough remedies, of cGMP produce local
bronchodilators bronchodilation.
Intranasal: Local
Pregnancy application inhibits
Category B secretions from
glands lining the nasal
mucosa.
Therapeutic Effects:
Inhaln: Bronchodilation
without systemic
anticholinergic effects.
Intranasal: Decreased
rhinorrhea.
Source:
Vallerand, A., Vallerand, A., Sanoski, C.,
Sanoski, C., & & Deglin, J. (2017). Drug
Deglin, J. (2017). Guide for Nurses. 15th Ed.
Drug Guide for FA Davis Company:
Nurses. 15th Ed. Philadelphia
FA Davis
Company:
Philadelphia
Indication Contraindication Side Effects Nursing Responsibilities
General Indications: Contraindicated in: CNS: dizziness, Before
Inhaln: Maintenance Hypersensitivity to headache, -Assess for allergy to atropine and
therapy of reversible ipratropium, atropine, nervousness. belladonna alkaloids; patients with
airway obstruction belladonna alkaloids, EENT: blurred these allergies may also be sensitive to
due to COPD, including or bromide; Avoid use vision, sore ipratropium. Atrovent HFA MDI does
chronic bronchitis and during acute throat; nasal not contain CFC or soy and may be
emphysema. bronchospasm; only, epistaxis, used safely in soy or
Intranasal: Rhinorrhea Note: Atrovent HFA nasal CFC-allergic patients. However,
associated with allergic has replaced the dryness/irritation Combivent MDI should be avoided in
and nonallergic perennial discontinued . soy or peanut-allergic patients.
rhinitis (0.03% solution) Atrovent CFC. Soy Resp: Inhaln:
or the common cold and CFC-allergic bronchospasm, -Assess respiratory status (rate, breath
(0.06% solution). patients can now cough. sounds, degree of dyspnea, pulse)
Unlabeled Use: safely use the CV: before administration and at peak of
Inhaln: Adjunctive Atrovent HFA hypotension, medication.
management of formulation. palpitations. -Caution patient to avoid spraying
bronchospasm caused by GI: GI irritation, medication in eyes; may cause
asthma. Use Cautiously in: nausea. blurring of vision or irritation
Patients with bladder Derm: rash. Nasal Spray:
Patient’s Indication: neck obstruction, Misc: allergic -Assess patient for rhinorrhea.
------------------- prostatic hyperplasia, reactions. - Instruct patient in proper use of nasal
glaucoma, or urinary spray. Clear nasal passages gently
retention; Geriatric before administration.
patients may be more
sensitive to effects -Wash hands before administration of
Source: Source: medication.
Vallerand, A., Sanoski, Vallerand, A., Sanoski, Source: -Check the doctor’s order.
C., & Deglin, J. (2017). C., & Deglin, J. Vallerand, A., -Verify pt’s identification.
Drug Guide for Nurses. (2017). Drug Guide for Sanoski, C., &
15th Ed. FA Davis Nurses. 15th Ed. FA Deglin, J. (2017). During
Company: Philadelphia Davis Company: Drug Guide for - Instruct patient in proper use of
Philadelphia Nurses. 15th Ed. inhaler, nebulizer, or nasal spray and
FA Davis to take medication as directed.
Company: Take missed doses as soon as
Philadelphia remembered unless almost time for the
next dose; space remaining
doses evenly during day. Do not
double doses.
-When ipratropium is administered
concurrently with other inhalation
medications, administer adrenergic
bronchodilators first, followed by
Duoneb).
Content:
Ipratropium bromide
anhydrous
Ipratropium bromide
monohydrate
Ipratropium chloride
Source:
Vallerand, A., Sanoski, C.,
& Deglin, J. (2017). Drug
Guide for Nurses. 15th Ed.
FA Davis Company:
Philadelphia
ipratropium, then corticosteroids. Wait
5 min between medications.
-Solution for nebulization can be
diluted with preservative- free 0.9%
NaCl. Diluted solution should be
used within 24 hr at room temperature
or 48 hr if refrigerated. Solution can
be mixed with preservative- free
albuterol, cromolyn, or metaproterenol
if used within 1 hr of mixing.
- Do not inhale during administration,
so medication
remains in nasal passages.
--Prime pump initially with 7
actuations. If used regularly, no
further priming is needed. If not used
in 24 hr, prime with 2 actuations. If
not used for more than 7 days, prime
with 7 actuations.
After
-Advise patient that rinsing mouth
after using inhaler, good oral hygiene,
and sugarless gum or candy may
minimize dry mouth. -Health care
professional
should be notified if stomatitis occurs
or if dry mouth persists for more than
2 wk.
Inhalation: Caution patient not to
exceed 12 doses within 24 hr. Patient
should notify health care professional
if symptoms do not improve within 30
min after administration of medication
or if condition worsens.
-Consult health care professional
about alternative medication if severe
bronchospasm is present; onset of
action is too slow for patients in acute
distress. If paradoxical bronchospasm
(wheezing) occurs, withhold
medication and notify health care
professional immediately.
-Explain need for pulmonary function
tests prior to and periodically during
therapy to determine effectiveness of
medication.
-Advise patient to inform health care
professional if cough, nervousness,
headache, dizziness, nausea, or
GI distress occurs.

- Advise patient to contact health care

professional if symptoms do not
improve within 1–2 wk or if condition
worsens.

Source:
Vallerand, A., Sanoski, C., & Deglin,
J. (2017). Drug Guide for Nurses. 15th
Ed. FA Davis Company: Philadelphia