Ipratropium
A short-acting inhaled antimuscarinic for bronchospasm in COPD; as a nasal spray it dries the runny nose of rhinitis.
Drug card
- How it works
- Blocking airway muscarinic receptors so vagal acetylcholine cannot narrow them
- Used for
- Maintenance bronchodilator in COPD
- Runny nose in perennial rhinitis (nasal spray)
- Known for
- Dry mouth
- Its name
- -trop- means an atropine-like antimuscarinic
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does ipratropium work?
A synthetic quaternary derivative of atropine that competitively blocks muscarinic receptors on bronchial smooth muscle. It cuts the vagal acetylcholine signal that raises calcium in the muscle cells, so the large central airways dilate. In the nose the same block reduces watery secretions.
Like other inhaled antimuscarinics: Inhaled antimuscarinics are quaternary relatives of atropine that compete with acetylcholine at muscarinic receptors, mainly M3, on airway smooth muscle and mucus glands. Acetylcholine released by the vagus nerve can then no longer tighten the airways or drive mucus secretion, so the airways widen. Their effect is mainly local in the lungs; ipratropium is short-acting and tiotropium lasts a full day.
Uses
What is ipratropium used for?
- Maintenance bronchodilator in COPD
- Runny nose in perennial rhinitis (nasal spray)
Side effects
Side effects of ipratropium
- Dry mouthKnown for
- Bitter taste
- Headache
- Dizziness
- Nausea
- Constipation
- Difficulty passing urine (urinary retention)Serious
- Narrow-angle glaucoma, blurred vision, eye painSerious
- Palpitations, fast or irregular heartbeat
- Paradoxical bronchospasmSerious
- Allergic reactions, including angioedemaSerious
- Nosebleeds (nasal spray)
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- It is not for the first treatment of acute bronchospasm, when rapid rescue is needed.
- Narrow-angle glaucoma: it can raise eye pressure, especially if sprayed into the eyes.
- Prostate enlargement or bladder-neck obstruction raises the risk of urinary retention.
- Allergy to atropine or its derivatives is a contraindication; other anticholinergics add to its effects.
Good to know: Short-acting, unlike tiotropium; it widens mainly the large central airways, and a nasal spray form treats watery rhinitis.
Remember it
A way to remember it
Block the vagus, open the airways.
The vagus nerve narrows the airways through acetylcholine at muscarinic receptors; these drugs block that signal, and like atropine they can dry the mouth and, rarely, raise eye pressure or hold back urine.
Written for biofideX
Its name
-trop- means atropine-like antimuscarinic
Marks atropine relatives. Ipratropium and tiotropium add -ium: as quaternary ammonium compounds they are barely absorbed and act in the airways. Somatropin, a growth hormone, fits by chance.
- Every drug name stem
Its class
Inhaled antimuscarinics
Other inhaled antimuscarinics with a card:
Easily mixed up with antimuscarinics, short-acting beta-2 agonists and long-acting beta-2 agonists.
Sources
Checked against
Written for biofideX in plain words, after checking these references:
- Ipratropium bromide HFA inhalation aerosol: label (DailyMed)
- Ipratropium bromide nasal solution: label (DailyMed)
- Ipratropium bromide (NCI Thesaurus)
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Lungs and allergy
Ipratropium is one of 16 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
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