SAMA·Respiratory - Asthma & COPD

Ipratropium

Acute asthma (severe), COPD maintenance and exacerbations

PBSSAMAAtrovent, Combivent (combo)Metered Dose Inhaler (21 mcg…S4+1

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

2000 mcg/day

Half-life

2 h

High risk: Glaucoma

AVOID SPRAY

Caution: Dry Mouth

COMMON

Cautions

Avoid / Cautions

Known hypersensitivity to atropine derivatives. Pregnancy Category B1.

Where it stands

Rapid Summary

Overview

Short-Acting Muscarinic Antagonist (SAMA). An anticholinergic bronchodilator. Acts purely locally in the airways to dry secretions and block vagal bronchoconstriction.

Clinical Focus

Escaping nebuliser mist hitting the eyes can precipitate acute angle-closure glaucoma.

Bottom Line

Ipratropium is a short-acting anticholinergic bronchodilator essential in acute severe asthma (with salbutamol) and COPD, but has slower onset than salbutamol and is not a standalone reliever.

Formulation & Access

Brand Names

Atrovent, Combivent (combo)

Oral Routes

Metered Dose Inhaler (21 mcg/actuation). Nebules (250 mcg/1 mL, 500 mcg/1 mL).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Acute asthma (severe), COPD maintenance and exacerbations.

Clinical Place

Added to SABA therapy for the first 24-48 hours of severe asthma/COPD exacerbations. Rarely used long-term anymore due to superiority of LAMAs (e.g., Tiotropium).

Quick reference

Class & Role

SAMA — Short-Acting Muscarinic Antagonist (SAMA).

Route / Formulation

Metered Dose Inhaler (21 mcg/actuation). Nebules (250 mcg/1 mL, 500 mcg/1 mL). (Atrovent, Combivent (combo))

Usual Dose & Max

Inhaled 500 mcg via nebuliser every 20 mins for 3 doses (mixed with Salbutamol), then q4-6h. Max 2000 mcg/day (via nebuliser).

Key Indication Doses

Acute Asthma (Severe): Inhaled 500 mcg via nebuliser every 20 mins for 3 doses (mixed with Salbutamol), then q4-6h. Acute COPD Exacerbation: Inhaled 500 mcg via nebuliser q4-6h. Often mixed with Salbutamol. Maintenance (MDI): Inhaled 2 puffs (21 mcg/puff) QID.

Best Uses

Ipratropium is a short-acting anticholinergic bronchodilator essential in acute severe asthma (with salbutamol) and COPD, but has slower onset than salbutamol and is not a standalone reliever.

Key Risks

Ocular: Nebulised mist in eyes can cause pupillary dilation and trigger acute angle-closure glaucoma. Gastrointestinal: Dry mouth, altered taste. Genitourinary: Urinary retention (especially in elderly men with BPH).

Key Interactions

Additive anticholinergic effects if given with TCAs, sedating antihistamines, or antipsychotics.

Monitoring

Monitor SpO2 and RR. Ask about eye pain or blurred vision post-nebulisation. No specific routine laboratory tests required.

Clinical Pearl

Elderly patients using an ill-fitting nebuliser mask will have the anticholinergic mist blow directly into their eyes. Always use a mouthpiece if possible, or ensure the mask is tightly sealed over the nose bridge.

Access

Atrovent, Combivent (combo)Metered Dose Inhaler (21 mcg…

Brand: Atrovent, Combivent (combo)
Formulation: Metered Dose Inhaler (21 mcg/actuation). Nebules (250 mcg/1 mL, 500 mcg/1 mL).

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.

SAMA·Respiratory - Asthma & COPD

Ipratropium

Acute asthma (severe), COPD maintenance and exacerbations

PBSSAMAAtrovent, Combivent (combo)Metered Dose Inhaler (21 mcg…S4+1

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

2000 mcg/day

Half-life

2 h

High risk: Glaucoma

AVOID SPRAY

Caution: Dry Mouth

COMMON

Cautions

Avoid / Cautions

Known hypersensitivity to atropine derivatives. Pregnancy Category B1.

Where it stands

Rapid Summary

Overview

Short-Acting Muscarinic Antagonist (SAMA). An anticholinergic bronchodilator. Acts purely locally in the airways to dry secretions and block vagal bronchoconstriction.

Clinical Focus

Escaping nebuliser mist hitting the eyes can precipitate acute angle-closure glaucoma.

Bottom Line

Ipratropium is a short-acting anticholinergic bronchodilator essential in acute severe asthma (with salbutamol) and COPD, but has slower onset than salbutamol and is not a standalone reliever.

Formulation & Access

Brand Names

Atrovent, Combivent (combo)

Oral Routes

Metered Dose Inhaler (21 mcg/actuation). Nebules (250 mcg/1 mL, 500 mcg/1 mL).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Acute asthma (severe), COPD maintenance and exacerbations.

Clinical Place

Added to SABA therapy for the first 24-48 hours of severe asthma/COPD exacerbations. Rarely used long-term anymore due to superiority of LAMAs (e.g., Tiotropium).

Quick reference

Class & Role

SAMA — Short-Acting Muscarinic Antagonist (SAMA).

Route / Formulation

Metered Dose Inhaler (21 mcg/actuation). Nebules (250 mcg/1 mL, 500 mcg/1 mL). (Atrovent, Combivent (combo))

Usual Dose & Max

Inhaled 500 mcg via nebuliser every 20 mins for 3 doses (mixed with Salbutamol), then q4-6h. Max 2000 mcg/day (via nebuliser).

Key Indication Doses

Best Uses

Ipratropium is a short-acting anticholinergic bronchodilator essential in acute severe asthma (with salbutamol) and COPD, but has slower onset than salbutamol and is not a standalone reliever.

Key Risks

Key Interactions

Additive anticholinergic effects if given with TCAs, sedating antihistamines, or antipsychotics.

Monitoring

Monitor SpO2 and RR. Ask about eye pain or blurred vision post-nebulisation. No specific routine laboratory tests required.

Clinical Pearl

Access

Atrovent, Combivent (combo)Metered Dose Inhaler (21 mcg…

Brand: Atrovent, Combivent (combo)
Formulation: Metered Dose Inhaler (21 mcg/actuation). Nebules (250 mcg/1 mL, 500 mcg/1 mL).

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.