I doser doses description
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If acute bronchospasm occurs during use, the ipratropium inhalation should be discontinued immediately and appropriate treatment measures instituted.
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It is recommended to 'test-spray' three times before using a new canister for the first time. Prescribers and patients should be aware of this precaution. This rare problem, when it occurs, is usually seen with the first inhalation from a newly opened canister. In addition, ipratropium aerosols can produce a paradoxical bronchospasm that can be life-threatening in some patients. Do not use ipratropium bromide products in those with ipratropium bromide hypersensitivity. Ipratropium is a derivative of and structurally similar to atropine as such, use is contraindicated in patients with atropine hypersensitivity or atropine derivative hypersensitivity. holding the face mask or open tube near the patient's nose and mouth) is not recommended.Īcute bronchospasm, bromide hypersensitivity, paradoxical bronchospasm The choice of using a mouthpiece versus a face mask must be made based on the skills and understanding of each individual patient. Nebulization solution may be mixed with albuterol in the nebulizer if used within one hour.ĭo not mix ipratropium with cromolyn nebulizer solutions they are not compatible. To avoid the spread of infection, do not use the inhaler for more than one person. If a face mask is used, allow 3-5 inhalations per actuation.Ī valved holding chamber and face mask should be used for children < 4 years.įollowing administration, instruct patient to rinse mouth with water to minimize dry mouth. However, in general, children < 4 years require administration with a tight fitting face mask and spacer/VHC device to achieve optimal delivery. The choice of using a mouthpiece versus a face mask with a spacer/VHC device must be made based on the skills and understanding of each individual patient. Instruct patient on proper inhalation technique (see patient information for the inhaler).įor patients of any age unable to coordinate inhalation and actuation, a spacer or valved holding chamber (VHC) should be used. No significant differences in FEV1 have been demonstrated between metered-dose inhalers (with or without a spacer) and nebulizers among short-acting bronchodilators in clinical trials nebulizers may be more convenient for more acutely ill patients. Titrate dosage according to patient response or the development of adverse effects. The optimal dosage of ipratropium for use during a COPD exacerbation has not been defined. Ipratropium may also be used with a short-acting beta-2 agonist for the treatment of acute COPD exacerbations. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines for COPD, ipratropium may be used as needed for first line therapy in Group A and may be used in Groups B, C, and D for additional symptom control. Max: Do not exceed 12 oral inhalations/day (204 mcg per 24 hours). Patients may take additional inhalations as required.
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2 oral inhalations (2 actuations of 17 mcg/actuation) 3 or 4 times per day (no more frequent than every 4 hours).