Ipratropium

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Ipratropium
File:Ipratropium.svg
Systematic (IUPAC) name
[8-methyl-8-(1-methylethyl)- 8-azoniabicyclo[3.2.1] oct-3-yl] 3-hydroxy-2-phenyl-propanoate
Clinical data
Pregnancy
category
  • US: B (No risk in non-human studies)
Routes of
administration
Inhalation
Legal status
Legal status
  • UK: POM (Prescription only)
Pharmacokinetic data
Protein binding 0 to 9% in vitro
Metabolism Hepatic
Biological half-life 2 hours
Identifiers
CAS Number 60205-81-4
ATC code R01AX03 (WHO) R03BB01
PubChem CID 43232
IUPHAR/BPS 325
DrugBank APRD00537
Chemical data
Formula C20H30NO3
Molar mass 332.457 g/mol[[Script error: No such module "String".]]
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Ipratropium (Atrovent, Apovent, Aerovent) is an anticholinergic drug.[1] It blocks the muscarinic cholinergic receptors in the smooth muscles of the bronchi in the lungs. This opens the bronchi, and provides relief in chronic obstructive pulmonary disease and acute asthma.

Uses

It is administered by inhalation for the treatment of obstructive lung diseases.

Ipratropium is also combined with albuterol (salbutamol) (trade names Combivent and Duoneb, in Italy known as Breva) for the management of chronic obstructive pulmonary disease (COPD) and asthma.

Ipratropium is also combined with fenoterol (trade names Duovent and Berodual N) for the management of asthma.

Ipratropium can reduce rhinorrhea but will not help nasal congestion.

Pharmacology

It blocks muscarinic cholinergic receptors, without specificity for subtypes, resulting in a decrease in the formation of cyclic guanosine monophosphate (cGMP). Most likely due to actions of cGMP on intracellular calcium, this results in decreased contractility of smooth muscle in the lung, inhibiting bronchoconstriction and mucus secretion. It is a non-selective muscarinic antagonist, and does not diffuse into the blood, which prevents systemic side-effects. Ipratropium is a derivative of atropine[2] but is a quaternary amine and therefore does not cross the blood-brain barrier, which prevents central side-effects (anticholinergic syndrome). Ipratropium is considered a short-acting bronchodilator.[3][4]

Side effects

If ipratropium is inhaled, side-effects resembling those of other anticholinergics are minimal. However, dry mouth and sedation have been reported. Also effects such as skin flushing, tachycardia, acute angle ocular dislocure, nausea, palpitations and headache have been observed. Ipratropium does not decrease mucuciliary clearance unlike other muscarininc antagonists.

See also

References

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de:Ipratropiumbromid

es:Ipratropio eu:Ipratropio fa:ایپراتروپیوم بروماید it:Ipratropio hu:Ipratropium pl:Bromek ipratropium pt:Ipratrópio

ru:Ипратропия бромид
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  2. Yamatake Y, Sasagawa S, Yanaura S, Okamiya Y (1977). "[Antiallergic asthma effect of ipratropium bromide (Sch 1000) in dogs (author's transl)]". Nippon Yakurigaku Zasshi (in Japanese). 73 (7): 785–91. PMID 145994. 
  3. Kerstjens HA, Bantje TA, Luursema PB; et al. (2007). "Effects of short-acting bronchodilators added to maintenance tiotropium therapy". Chest. 132 (5): 1493–9. doi:10.1378/chest.06-3059. PMID 17890476. 
  4. Knott L (November 20, 2007). "Antimuscarinic Bronchodilators". PatientUK. EMIS. Retrieved 2008-06-16.