A muscarinic antagonist structurally related to ATROPINE but often considered safer and more effective for inhalation use. It is used for various bronchial disorders, in rhinitis, and as an antiarrhythmic.
Analogs and derivatives of atropine.
A short-acting beta-2 adrenergic agonist that is primarily used as a bronchodilator agent to treat ASTHMA. Albuterol is prepared as a racemic mixture of R(-) and S(+) stereoisomers. The stereospecific preparation of R(-) isomer of albuterol is referred to as levalbuterol.
Agents that cause an increase in the expansion of a bronchus or bronchial tubes.
Analogs or derivatives of scopolamine.
Drugs that bind to but do not activate CHOLINERGIC RECEPTORS, thereby blocking the actions of ACETYLCHOLINE or cholinergic agonists.
An adrenergic beta-2 agonist that is used as a bronchodilator and tocolytic.
Devices that cause a liquid or solid to be converted into an aerosol (spray) or a vapor. It is used in drug administration by inhalation, humidification of ambient air, and in certain analytical instruments.
Any disorder marked by obstruction of conducting airways of the lung. AIRWAY OBSTRUCTION may be acute, chronic, intermittent, or persistent.
Colloids with a gaseous dispersing phase and either liquid (fog) or solid (smoke) dispersed phase; used in fumigation or in inhalation therapy; may contain propellant agents.
The administration of drugs by the respiratory route. It includes insufflation into the respiratory tract.
A chromone complex that acts by inhibiting the release of chemical mediators from sensitized mast cells. It is used in the prophylactic treatment of both allergic and exercise-induced asthma, but does not affect an established asthmatic attack.
Measure of the maximum amount of air that can be expelled in a given number of seconds during a FORCED VITAL CAPACITY determination . It is usually given as FEV followed by a subscript indicating the number of seconds over which the measurement is made, although it is sometimes given as a percentage of forced vital capacity.
A muscarinic antagonist used as an antispasmodic, in some disorders of the gastrointestinal tract, and to reduce salivation with some anesthetics.
The quality of not being miscible with another given substance without a chemical change. One drug is not of suitable composition to be combined or mixed with another agent or substance. The incompatibility usually results in an undesirable reaction, including chemical alteration or destruction. (Dorland, 27th ed; Stedman, 25th ed)
Measurement of the maximum rate of airflow attained during a FORCED VITAL CAPACITY determination. Common abbreviations are PEFR and PFR.
A shift in the balance between production and destruction of STRATOSPHERIC OZONE that results in a decline of the amount of OZONE in the lower stratosphere.
A beta-2 adrenergic agonist used in the treatment of ASTHMA and BRONCHIAL SPASM.
A form of bronchial disorder with three distinct components: airway hyper-responsiveness (RESPIRATORY HYPERSENSITIVITY), airway INFLAMMATION, and intermittent AIRWAY OBSTRUCTION. It is characterized by spasmodic contraction of airway smooth muscle, WHEEZING, and dyspnea (DYSPNEA, PAROXYSMAL).
Physiologically, the opposition to flow of air caused by the forces of friction. As a part of pulmonary function testing, it is the ratio of driving pressure to the rate of air flow.
A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment.
Drugs that bind to but do not activate MUSCARINIC RECEPTORS, thereby blocking the actions of endogenous ACETYLCHOLINE or exogenous agonists. Muscarinic antagonists have widespread effects including actions on the iris and ciliary muscle of the eye, the heart and blood vessels, secretions of the respiratory tract, GI system, and salivary glands, GI motility, urinary bladder tone, and the central nervous system.
A selective beta-2 adrenergic agonist used as a bronchodilator and tocolytic.
A disease of chronic diffuse irreversible airflow obstruction. Subcategories of COPD include CHRONIC BRONCHITIS and PULMONARY EMPHYSEMA.
Substances which are of little or no therapeutic value, but are necessary in the manufacture, compounding, storage, etc., of pharmaceutical preparations or drug dosage forms. They include SOLVENTS, diluting agents, and suspending agents, and emulsifying agents. Also, ANTIOXIDANTS; PRESERVATIVES, PHARMACEUTICAL; COLORING AGENTS; FLAVORING AGENTS; VEHICLES; EXCIPIENTS; OINTMENT BASES.
Inflammation of the large airways in the lung including any part of the BRONCHI, from the PRIMARY BRONCHI to the TERTIARY BRONCHI.
A histamine H1 antagonist used as the hydrogen fumarate in hay fever, rhinitis, allergic skin conditions, and pruritus. It causes drowsiness.
Measurement of the various processes involved in the act of respiration: inspiration, expiration, oxygen and carbon dioxide exchange, lung volume and compliance, etc.
Narrowing of the caliber of the BRONCHI, physiologically or as a result of pharmacological intervention.
The volume of air that is exhaled by a maximal expiration following a maximal inspiration.
A series of hydrocarbons containing both chlorine and fluorine. These have been used as refrigerants, blowing agents, cleaning fluids, solvents, and as fire extinguishing agents. They have been shown to cause stratospheric ozone depletion and have been banned for many uses.
Care of patients with deficiencies and abnormalities associated with the cardiopulmonary system. It includes the therapeutic use of medical gases and their administrative apparatus, environmental control systems, humidification, aerosols, ventilatory support, bronchopulmonary drainage and exercise, respiratory rehabilitation, assistance with cardiopulmonary resuscitation, and maintenance of natural, artificial, and mechanical airways.
The process of keeping pharmaceutical products in an appropriate location.
Drugs that selectively bind to and activate beta-adrenergic receptors.

Risk factors for death from asthma, chronic obstructive pulmonary disease, and cardiovascular disease after a hospital admission for asthma. (1/213)

BACKGROUND: Patients with asthma have an increased risk of death from causes other than asthma. A study was undertaken to identify whether severity of asthma, its treatment, or associated co-morbidity were associated with increased risk of death from other causes. METHODS: Eighty five deaths from all causes occurring within three years of discharge from hospital in a cohort of 2242 subjects aged 16-64 years admitted for asthma were compared with a random sample of 61 controls aged <45 years and 61 aged >/=45 years from the same cohort. RESULTS: Deaths from asthma were associated with a history of clinically severe asthma (OR 6.29 (95% CI 1.84 to 21.52)), chest pain (OR 3.78 (95% CI 1.06 to 13.5)), biochemical or haematological abnormalities at admission (OR 4.12 (95% CI 1.36 to 12.49)), prescription of ipratropium bromide (OR 4.04 (95% CI 1.47 to 11.13)), and failure to prescribe inhaled steroids on discharge (OR 3.45 (95% CI 1.35 to 9.10)). Deaths from chronic obstructive pulmonary disease (COPD) were associated with lower peak expiratory flow rates (OR 2.56 (95% CI 1.52 to 4.35) for each 50 l/min change), a history of smoking (OR 5.03 (95% CI 1.17 to 21.58)), prescription of ipratropium bromide (OR 7.75 (95% CI 2.21 to 27.14)), and failure to prescribe inhaled steroids on discharge (OR 3.33 (95% CI 0.95 to 11.10)). Cardiovascular deaths were more common among those prescribed ipratropium bromide on discharge (OR 3.55 (95% CI 1.05 to 11.94)) and less likely in those admitted after an upper respiratory tract infection (OR 0.21 (95% CI 0.05 to 0.95)). Treatment with ipratropium bromide at discharge was associated with an increased risk of death from asthma even after adjusting for peak flow, COPD and cardiovascular co-morbidity, ever having smoked, and age at onset of asthma. CONCLUSIONS: Prescription of inhaled steroids on discharge is important even for those patients with co-existent COPD and asthma. Treatment with ipratropium at discharge is associated with increased risk of death from asthma even after adjustment for a range of markers of COPD. These results need to be tested in larger studies.  (+info)

Airway hyperresponsiveness to ultrasonically nebulized distilled water in subjects with tetraplegia. (2/213)

The majority of otherwise healthy subjects with chronic cervical spinal cord injury (SCI) demonstrate airway hyperresponsiveness to aerosolized methacholine or histamine. The present study was performed to determine whether ultrasonically nebulized distilled water (UNDW) induces airway hyperresponsiveness and to further elucidate potential mechanisms in this population. Fifteen subjects with SCI, nine with tetraplegia (C4-7) and six with paraplegia (T9-L1), were initially exposed to UNDW for 30 s; spirometry was performed immediately and again 2 min after exposure. The challenge continued by progressively increasing exposure time until the forced expiratory volume in 1 s decreased 20% or more from baseline (PD20) or the maximal exposure time was reached. Five subjects responding to UNDW returned for a second challenge 30 min after inhalation of aerosolized ipratropium bromide (2.5 ml of a 0.6% solution). Eight of nine subjects with tetraplegia had significant bronchoconstrictor responses to UNDW (geometric mean PD20 = 7.76 +/- 7.67 ml), whereas none with paraplegia demonstrated a response (geometric mean PD20 = 24 ml). Five of the subjects with tetraplegia who initially responded to distilled water (geometric mean PD20 = 5.99 +/- 4.47 ml) were not responsive after pretreatment with ipratropium bromide (geometric mean PD20 = 24 ml). Findings that subjects with tetraplegia are hyperreactive to UNDW, a physicochemical agent, combined with previous observations of hyperreactivity to methacholine and histamine, suggest that overall airway hyperresponsiveness in these individuals is a nonspecific phenomenon similar to that observed in patients with asthma. The ability of ipratropium bromide to completely block UNDW-induced bronchoconstriction suggests that, in part, airway hyperresponsiveness in subjects with tetraplegia represents unopposed parasympathetic activity.  (+info)

Changes in airway resistance induced by nasal or oral intermittent positive pressure ventilation in normal individuals. (3/213)

Nasal intermittent positive-pressure ventilation (nIPPV) is used for the treatment of respiratory failure in patients with neuromuscular disease. The aim of the present study was to demonstrate that nIPPV may activate nose receptors, the consequence of which being reflex changes in lung resistance. The changes in interrupter resistances (Rint) in response to nIPPV were tested before and after local anaesthesia of the nasal mucosa in normal subjects. They were compared to the Rint changes induced by oral intermittent positive-pressure ventilation (oIPPV) in the same individuals. Rint was measured during 10-min periods of nIPPV or oIPPV at a constant rate (15 L x min(-1)), but at two different stroke volumes (0.8 and 1.2 L). Inspired temperature and relative humidity were held constant. nIPPV with 1.2 L (17 mL x kg(-1)) significantly increased the Rint value (+22%). This effect disappeared after nose anaesthesia or after inhalation of a cholinergic antagonist. oIPPV never changed Rint, even though the associated hypocapnia was present and more accentuated than during nIPPV. Adding CO2 to the inspired gas during nIPPV and oIPPV trials suppressed the Rint changes. The present study suggests the existence of a nasopulmonary bronchoconstrictor reflex elicited through the stimulation of nasal mechanoreceptors, their activity being markedly influenced by the changes in expired CO2 concentration.  (+info)

Pharmacological characterization of the muscarinic receptor antagonist, glycopyrrolate, in human and guinea-pig airways. (4/213)

1. In this study we have evaluated the pharmacological profile of the muscarinic antagonist glycopyrrolate in guinea-pig and human airways in comparison with the commonly used antagonist ipratropium bromide. 2. Glycopyrrolate and ipratropium bromide inhibited EFS-induced contraction of guinea-pig trachea and human airways in a concentration-dependent manner. Glycopyrrolate was more potent than ipratropium bromide. 3. The onset of action (time to attainment of 50% of maximum response) of glycopyrrolate was similar to that obtained with ipratropium bromide in both preparations. In guinea-pig trachea, the offset of action (time taken for response to return to 50% recovery after wash out of the test antagonist) for glycopyrrolate (t1/2 [offset]=26.4+/-0.5 min) was less than that obtained with ipratropium bromide (81.2+/-3.7 min). In human airways, however, the duration of action of glycopyrrolate (t1/2 [offset]>96 min) was significantly more prolonged compared to ipratropium bromide (t1/2 [offset]= 59.2+/-17.8 min). 4. In competition studies, glycopyrrolate and ipratropium bromide bind human peripheral lung and human airway smooth muscle (HASM) muscarinic receptors with affinities in the nanomolar range (K1 values 0.5-3.6 nM). Similar to ipratropium bromide, glycopyrrolate showed no selectivity in its binding to the M1-M3 receptors. Kinetics studies, however, showed that glycopyrrolate dissociates slowly from HASM muscarinic receptors (60% protection against [3H]-NMS binding at 30 nM) compared to ipratropium bromide. 5. These results suggest that glycopyrrolate bind human and guinea-pig airway muscarinic receptors with high affinity. Furthermore, we suggest that the slow dissociation profile of glycopyrrolate might be the underlying mechanism by which this drug accomplishes its long duration of action.  (+info)

An empirical comparison of the St George's Respiratory Questionnaire (SGRQ) and the Chronic Respiratory Disease Questionnaire (CRQ) in a clinical trial setting. (5/213)

BACKGROUND: The Chronic Respiratory Questionnaire (CRQ) and the St George's Respiratory Questionnaire (SGRQ) are the two most widely used quality of life questionnaires in chronic obstructive pulmonary disease (COPD). A study was undertaken to compare directly the self-administered version of the CRQ and the SGRQ with respect to feasibility, internal consistency, validity, and sensitivity to changes resulting from bronchodilator therapy. METHODS: One hundred and forty four patients with moderate or severe COPD were randomly assigned to receive three months of treatment with either salmeterol, salmeterol + ipratropium bromide, or placebo. Quality of life was measured at baseline and after 12 weeks of treatment. RESULTS: The proportions of missing values per patient were low for both questionnaires (0.54% for the CRQ and 2% for the SGRQ). The internal consistency was good for both questionnaires (Cronbach's alpha coefficients >/= 0.84 for the CRQ and >/= 0.76 for the SGRQ). Factor analysis confirmed the original domain structure of the CRQ but not of the SGRQ. Correlations with forced expiratory volume in one second (FEV(1)) % predicted and peak expiratory flow rate (PEFR) were low for both questionnaires but better for the SGRQ than for the CRQ. The ability to discriminate between subjects with different levels of FEV(1) was somewhat better for the SGRQ. The correlations with symptom scores were comparable for both questionnaires. Cross sectionally, the scores of the two questionnaires were moderately to highly correlated (coefficients ranged from 0.35 to 0.72). Longitudinally, these correlations were lower (coefficients ranged from 0.17 to 0.54) but were still significant. The CRQ total and emotions score and the SGRQ symptoms score were the most responsive to change. The SGRQ symptoms domain was the only domain where the improvement in patients receiving combination treatment crossed the threshold for clinical relevance. CONCLUSIONS: Since this analysis of reliability, validity, and responsiveness to change did not clearly favour one instrument above the other, the choice between the CRQ and the SGRQ can be based on other considerations such as the required sample size or the availability of reference values.  (+info)

Laser Doppler flowmetry as a measure of extrinsic colonic innervation in functional bowel disease. (6/213)

BACKGROUND: In functional disorders it is unknown whether disturbed function is due to an intrinsic gut abnormality or altered extrinsic innervation. AIMS: To study whether measurement of mucosal blood flow could be used as a quantitative direct measure of gut extrinsic nerve autonomic activity in patients with idiopathic constipation. METHODS: Seventy two patients with idiopathic constipation and 26 healthy volunteers had rectal mucosal blood flow measurements by a laser Doppler flowmetry probe applied 10 cm from the anus. Measurements were made at rest and after inhaled placebo and ipratropium 40 microg. RESULTS: Constipated subjects had lower baseline rectal blood flow than controls. Patients with slow transit had lower mucosal blood flow than normal transit. The number of retained markers on x-ray was inversely correlated with blood flow. Ipratropium reduced blood flow compared with placebo, reduced it less in constipated patients than controls, and reduced it less in patients with slow compared with normal transit. Constipated patients, not controls, showed a significantly attenuated RR interval (the interval between successive R waves on the ECG) variability, and blood flow correlated with vagal function. CONCLUSIONS: Laser Doppler mucosal flowmetry is a gut specific, quantitative measure of extrinsic autonomic nerve activity. The technique has shown that patients with idiopathic constipation have impaired extrinsic gut nerve activity, and this is more notable in those with slow transit. The degree of slow transit correlates with the degree of impaired extrinsic innervation.  (+info)

Lack of association between ipratropium bromide and mortality in elderly patients with chronic obstructive airway disease. (7/213)

BACKGROUND: Ipratropium is commonly used for the management of elderly patients with obstructive airway disease. However, a recent report suggested that its use might be associated with a significant increase in mortality. A study was therefore conducted to compare all-cause mortality rates between users and non-users of ipratropium in elderly patients with either asthma or chronic obstructive pulmonary disease (COPD). METHODS: A retrospective cohort study was performed using linked data from the Canadian Institute for Health Information, the Ontario Drug Benefit Program, the Ontario Health Insurance Plan, and the Ontario Registered Persons database. A total of 32 393 patients were identified who were aged 65 years or older and who had been discharged from hospital with asthma or COPD between 1 April 1992 and 31 March 1997. All-cause mortality rates were compared between those treated and those not treated with ipratropium following discharge from hospital. RESULTS: In total, 49% of patients received ipratropium within 90 days of discharge. After adjusting for age, sex, comorbidity, use of health services, and other airway medications there was no significant association in patients with COPD between the use of ipratropium and mortality (relative risk (RR) 1.03; 95% confidence interval (CI) 0.98 to 1.08). In patients with asthma, however, there was a slight increase in the relative risk of mortality associated with the use of ipratropium (RR 1.24; 95% CI 1.11 to 1.39). A dose-response increase in the mortality rate was not observed with increasing use of ipratropium in either COPD or asthma. CONCLUSIONS: The use of ipratropium in patients with COPD was not associated with an increase in mortality. However, in asthma there was a small increase in the mortality rate. Since asthmatic patients who received ipratropium had greater use of other airway medications and health services, the difference in mortality rate between users and non-users may be a reflection of unmeasured differences in asthma severity.  (+info)

A randomised controlled comparison of tiotropium nd ipratropium in the treatment of chronic obstructive pulmonary disease. The Dutch Tiotropium Study Group. (8/213)

BACKGROUND: A study was undertaken to evaluate and compare the efficacy and safety of tiotropium and ipratropium during long term treatment in patients with stable chronic obstructive pulmonary disease (COPD). METHODS: 288 patients of mean (SD) age 65 (8) years and forced expiratory volume in one second (FEV(1)) 41 (12)% predicted participated in a 14 centre, double blind, double dummy, parallel group study and were randomised after a run in period of two weeks to receive either tiotropium 18 microg once daily from a dry powder inhaler (HandiHaler; two thirds of patients) or ipratropium 40 microg four times daily from a metered dose inhaler (one third of patients) for a period of 13 weeks. Outcome measures were lung function, daily records of peak expiratory flow (PEF), and the use of concomitant salbutamol. FEV(1) and forced vital capacity (FVC) were measured one hour before and immediately before inhalation (mean value of the two measurements on test day 1 was the baseline value while on all other test days it was known as the trough FEV(1) and FVC), and 0.5, 1, 2, 3, 4, 5, and 6 hours after inhalation of the study drug on days 1, 8, 50, and 92. RESULTS: During treatment tiotropium achieved a significantly greater improvement than ipratropium (p<0.05) in trough, average, and peak FEV(1) levels and in trough and average FVC levels. The trough FEV(1) response on days 8, 50, and 92 ranged between 0.15 l (95% CI 0.11 to 0.19) and 0.16 l (95% CI 0.12 to 0.20) for tiotropium and between 0.01 l (95% CI -0.03 to 0.05) and 0.03 l (95% CI 0.01 to 0. 07) for ipratropium. The trough FVC response on days 8, 50, and 92 ranged between 0.34 l (95% CI 0.28 to 0.40) and 0.39 l (95% CI 0.31 to 0.47) for tiotropium and between 0.08 l (95% CI 0.00 to 0.16) and 0.18 l (95% CI 0.08 to 0.28) for ipratropium. On all test days tiotropium produced a greater improvement in FEV(1) than ipratropium starting three hours after inhalation (p<0.05). During treatment weekly mean morning and evening peak expiratory flow (PEF) was consistently better in the tiotropium group than in the ipratropium group, the difference in morning PEF being significant up through week 10 and in evening PEF up through week 7 of treatment (p<0.05). The use of concomitant salbutamol was also lower in the tiotropium group (p<0.05). The only drug related adverse event was dry mouth (tiotropium 14.7%, ipratropium 10.3% of patients). CONCLUSIONS: Tiotropium in a dose of 18 microg inhaled once daily using the HandiHaler was significantly more effective than 40 microg ipratropium four times daily in improving trough, average, and peak lung function over the 13 week period. The safety profile of tiotropium was similar to ipratropium. These data support the use of tiotropium as first line treatment for the long term maintenance treatment of patients with airflow obstruction due to COPD.  (+info)

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Drug withdrawal before oral aspirin challenge procedures: Short-acting b 2-agonists 6 h (8 h, if possible) Ipratropium bromide 6 h (8 h, if possible).SPIRIVA - SPIRIVA RESPIMAT - SPIRIVA - CT 9435 - English version: Introduction SPIRIVA 18 microgram, inhalation powder, hard capsule B/30 capsules with inhaler (CIP.Intranasal ipratropium bromide has been shown to significantly reduce rhinorrhea. Use of a freon-propelled intranasal preparation has resulted in side effects.Australia HFC MDI Ipratropium Atrovent™ Boehringer Ingelheim Import Oct-03. Belgium HFC MDI Ipratropium bromide Atrovent™ HFA Boehringer Ingelheim Mar-04.Quiz Drugs (EMT): Drug dosages and. What is the dose for ipratropium bromide? 10 puffs q 20 mins to a total of 30 puffs 5 puffs q 20 mins to a total of 15 puffs.. The legally binding text is the original French version. the place of aclidinium bromide in the therapeutic strategy. Ipratropium ATROVENT 20 µg per.ipratropium bromide 0.5 mg and albuterol sulfate Ventolin and ...
General. Ipratropium bromide should be used with caution in patients with narrow angle glaucoma, prostatic hypertrophy or bladder neck obstruction.. Information for Patients. Patients should be advised that temporary blurring of vision, precipitation or worsening of narrow-angle glaucoma or eye pain may result if the solution comes into direct contact with the eyes. Use of a nebulizer with mouthpiece rather than face mask may be preferable, to reduce the likelihood of the nebulizer solution reaching the eyes. Patients should be advised that Ipratropium Bromide Inhalation Solution can be mixed in the nebulizer with albuterol or metaproterenol if used within one hour. Drug stability and safety of ipratropium bromide inhalation solution when mixed with other drugs in a nebulizer have not been established. Patients should be reminded that Ipratropium Bromide Inhalation Solution should be used consistently as prescribed throughout the course of therapy.. Drug Interactions. Ipratropium bromide has ...
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Ipratropium bromide, sold under the trade name Atrovent among others, is a medication which opens up the medium and large airways in the lungs.[1] It is used to treat the symptoms of chronic obstructive pulmonary disease and asthma.[1] It is used by inhaler or nebulizer.[1] Onset of action is typically within 15 to 30 minutes and lasts for three to five hours.[1] Common side effects include dry mouth, cough, and inflammation of the airways.[1] Potentially serious side effects include urinary retention, worsening spasms of the airways, and a severe allergic reaction.[1] It appears to be safe in pregnancy and breastfeeding.[1][2] Ipratropium is a muscarinic antagonist, a type of anticholinergic, which works by causing smooth muscles to relax.[1] Ipratropium bromide was developed in Germany in 1976.[3] It was approved for medical use in the United States in 1986.[1] It is on the World Health Organizations List of Essential Medicines, the most effective and safe medicines needed in a health ...
Ipratropium is administered by inhalation for the treatment of chronic obstructive pulmonary disease (COPD) as well as asthma.. Ipratropium blocks muscarinic acetylcholine receptors, without specificity for subtypes, and therefore inhibits degradation of cyclic guanosine monophosphate (cGMP), resulting in an intracellular increase of cGMP concentration. 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 nonselective muscarinic antagonist, and does not diffuse into the blood, which prevents systemic side effects. Ipratropium is a derivative of atropine[3] but is a quaternary amine and therefore does not cross the blood-brain barrier, which should prevent central side effects (anticholinergic syndrome). Ipratropium is considered a short-acting bronchodilator.[4][5]. ...
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The combination preparation ipratropium bromide/salbutamol is a formulation containing ipratropium bromide (an anticholinergic) and salbutamol sulfate (albuterol sulfate, a β2-adrenergic receptor agonist) used in the management of chronic obstructive pulmonary disease (COPD) and asthma. It is marketed by Boehringer Ingelheim as a metered dose inhaler (MDI) and nebuliser under the trade name Combivent. It is also marketed by Dey, L.P. (Napa, California) under the brand name DuoNeb as a nebulizer. In Italy it is known as Breva. The chemical is sold in India by Cipla as duolin. Since Combivent contains a chlorofluorocarbon based propellant, it is being phased out in European Union countries. Chloroflourocarbons (CFC) are attributed to depletion of the ozone layer. Consumer Medication Information from PubMed http://bidocs.boehringer-ingelheim.com/BIWebAccess/ViewServlet.ser?docBase=renetnt&folderPath=/Prescribing+Information/PIs/Combivent+IA/combivent.pdf Expert Panel 3. Expert panel report 3: ...
Ipratropium bromide. Molecular model of the anticholinergic drug ipratropium bromide (C20.H30.Br.N.O3). This is used for the treatment of chronic obstructive pulmonary disease and acute asthma. It acts by blocking acetylcholine receptors. Atoms are represented as spheres and are colour-coded: carbon (grey), hydrogen (white), nitrogen (blue), oxygen (red) and bromine (brown, bromine ion at left). Illustration. - Stock Image F016/9809
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Ipratropium and tiotropium are inhaled drugs that act as muscarinic antagonists. By blocking muscarinic or parasympathetic signalling at the bronchioles, these drugs induce bronchodilation, which may be useful in the treatment of asthma or COPD. Ipratropium and Tiotropium differ mainly by their duration of action. Ipratropium is short-acting, which means it is best suited for acute resolution of asthma attacks or COPD exacerbations. In contrast, tiotropium is long-acting, making it preferred for chronic maintenance of these diseases.
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Combivent is prescribed to treat chronic obstructive pulmonary disease. The medication works by dilating and enlarging the airways via relaxation of the muscles of respiratory tract.
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Ipratropium Bromide is a short-acting (lasting for 6-8 h) anticholinergic bronchodilator used in the management of chronic obstructive pulmonary disease (COPD). The aim o..
It is a short acting b2 adrenergic receptor agonist used for relief of bronchospasm in condition like asthma and COPD. It is also used as tocolytic to delay premature labour by relaxing the uterine...
Rinatec nasal spray contains the active ingredient ipratropium bromide, which is a type of medicine known as an antimuscarinic (sometimes called an anticholinergic).
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Ipratropium is a muscarinic receptor antagonist. Ipratropium will be used in treating patient with asthma and patient with chronic obstructive pulmonary disease.
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Albuterol; Ipratropium inhalation aerosol and solution What are albuterol; ipratropium inhalation aerosol and solution? ALBUTEROL; IPRATROPIUM (Combivent®, DuoNeb™) is a combination of bronchodilators, which are medicines that open up your air passages and make breathing easier. The combination is used for patients with lung problems such as chronic bronchitis and emphysema. This medicine controls acute episodes or prevents recurring bouts of bronchospasm due to these conditions. Generic albuterol; ipratropium inhalation aerosols and nebulizer solutions are not yet available. What should my health care professional know before I use albuterol; ipratropium inhalation? They need to know if you have any of the following conditions: •bladder problems or difficulty passing urine •diabetes •glaucoma •heart disease, angina, or irregular heartbeat •high blood pressure •liver or kidney disease •prostate trouble •overactive thyroid gland •pheochromocytoma •seizures (convulsions) ...
Inhaled ipratropium may cause the following side effects: chest pain; rapid heartbeat; breathlessness; wheezing; dizziness; fainting; eye pain or blur
Email. LEXINGTON, Ky. - Trainer Kiaran McLaughlin began serving three concurrent 30-day suspensions on Tuesday after three horses in his care tested positive for a rarely used bronchial dilator following races at Keeneland in October, in a case that illustrates the dangers trainers face when using little-known medications. The bronchial dilator, ipratropium bromide, has been widely available for decades to treat lung problems such as asthma in humans. The drug, however, is not approved for use in horses by the Food and Drug Administration, and trainers, veterinarians, and testing officials have very little information to guide the proper use of the medication, especially when horses ship from states using less sensitive testing methods to those using more sensitive technologies. McLaughlin, who is based in New York and runs one of the most high-profile barns in the country, said that he had been using ipratropium bromide on the advice of his veterinarian to treat reactions to hay dust, using a ...
Rationale:. Inhaled bronchodilators, beta-2-agonist or anticholinergic or combinations, can be delivered by several types of devices: dry powder (DPI), pressurized metered dose inhalers (pMDI), and wet nebulizers. Wet nebulization is available for short-acting bronchodilators only, is cumbersome, and, importantly, has never been scientifically been proven to be more efficacious than delivery by the other two methods. Yet many patients are happy with wet nebulization and in many clinics this administration method prevails. The investigators believe that combined long-acting bronchodilators, are more efficacious than combined short acting bronchodilators per nebulizers.. Objective:. To test the hypothesis that: The combination of the two long-acting bronchodilators indacaterol and glycopyrronium by dry powder inhalation confers a superior improvement compared to nebulisation with ipratropium/salbutamol, when administered as single dose in patients with stable state chronic obstructive pulmonary ...
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Combivent (ipratropium / albuterol) is effective for people who need 2 medications to control their COPD symptoms, but has to be used 4 times a day. No generic form of the inhaler is currently available, so it can be very expensive for people without insurance.
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The IUPHAR/BPS Guide to Pharmacology. ipratropium ligand page. Quantitative data and detailed annnotation of the targets of licensed and experimental drugs.
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Combivent is prescribed to treat chronic obstructive pulmonary disease. The medication works by dilating and enlarging the airways via relaxation of the muscles of respiratory tract.
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06% is a metered-dose, manual pump spray unit which delivers 42 mcg ipratropium bromide (on an anhydrous basis) per spray (70 μL) in an isotonic aqueous solution, pH-adjusted to 4. Distinction between the common cold and acute bronchitis is often impossible to make and usually clinically irrelevant in otherwise healthy persons. Where Can I Buy Atrovent Buy Atrovent Inhaler 20 mcg online at Online Pharmacies Canada at a discounted price, we also offer this product with a buySAFE guarantee Atrovent is an Valtrex Order Online easy to use preventative inhaler for asthma and COPD Atrovent HFA inhaler is used to the cost of Long. Where Can I Buy Atrovent hobbies games people play-lf youre a game, this is the place for you. Atrovent HFA (Ipratropium Bromide) and/or alternatives . 30 Day Returns. The doctor will give special recommendations, prescribe examination and then, it will be possible to use this medicine safely. If the opportunity to see a doctor is restricted, it is possible to buy Atrovent ...
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The safety of Atrovent® (ipratropium bromide) Nasal Spray 0.06% at a dose of two sprays (84 mcg) per nostril three times a day (total dose 504 mcg/day) for two to four days has been demonstrated in two clinical trials involving 362 pediatric patients 5-11 years of age with naturally acquired common colds. In this pediatric population ATROVENT Nasal Spray 0.06% had an adverse event profile similar to that observed in adolescent and adult patients. When ATROVENT Nasal Spray 0.06% was concomitantly administered with an oral decongestant (pseudoephedrine HCl) in 122 children ages 5-12 years, and concomitantly administered with an oral decongestant/antihistamine combination (pseudoephedrine HCl/chlorpheniramine maleate) in 123 children ages 5-12 years, adverse event profiles were similar to ATROVENT Nasal Spray 0.06% alone. The safety of ATROVENT Nasal Spray 0.06% at a dose of two sprays (84 mcg) per nostril four times a day (total dose 672 mcg/day) for three weeks in pediatric seasonal allergic ...
TY - JOUR. T1 - In chronic obstructive pulmonary disease, a combination of ipratropium and albuterol is more effective than either agent alone. T2 - An 85-day multicenter trial. AU - Bone, R.. AU - Boyars, M.. AU - Braun, S. R.. AU - Buist, A. S.. AU - Campbell, S.. AU - Chick, T.. AU - Cohen, B. M.. AU - Conway, W.. AU - Cugell, D. W.. AU - DeGraff, A.. AU - Friedman, M.. AU - George, R. B.. AU - Gershwin, E.. AU - Kram, J. A.. AU - Levin, D. C.. AU - Levine, B.. AU - Petty, T. L.. AU - Rennard, S.. AU - Repsher, L.. PY - 1994. Y1 - 1994. N2 - Combination bronchodilator therapy for chronic obstructive pulmonary disease (COPD) is available widely throughout the world except in North America. Previous studies have yielded conflicting results regarding the advantages of combining anticholinergic therapy with sympathomimetic therapy in COPD. We report the results of a 12-week prospective, double-blind, parallel-group evaluation of the use of the following: albuterol, a β- adrenergic agent; ...
Once it has been discovered that you are taking Ipratropium or Atrovent, the next step will be to determine how well it is managing your pre-existing lung condition. From there…
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Introduction. Stress-induced cardiomyopathy, also known as broken heart syndrome or Takotsubo cardiomyopathy (TC), is characterized by transient systolic dysfunction of the apical and/or mid segments of the left ventricle that mimics myocardial infarction, in the absence of significant obstructive coronary artery disease.1 There is often a history of recent emotional or physical stress or severe acute illness. Stress cardiomyopathy has been described in patients with chronic obstructive pulmonary disease (COPD).2-7. Case report. A 56-year-old Caucasian patient with COPD (irregularly treated with tiotropium bromide, acetylcysteine and mometasone) was admitted to the emergency room (ER) of our hospital with dyspnea and cough with sputum for two weeks. On admission to the ER, the patient was hemodynamically stable (systolic/diastolic blood pressure: 126/65 mmHg; heart rate: 98 bpm), eupneic at rest and with fever (39.1°C). Pulmonary auscultation revealed rumbles in the left hemithorax. The chest ...
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Children who present to the emergency department during a severe exacerbation of asthma are typically treated with inhaled beta agonists and corticosteroids. Despite optimal use of these agents, many children require hospital admission for continued treatment. Several studies have shown that pulmonary function improves when the anticholinergic agent ipratropium bromide is given with a beta agonist, such as albuterol. Qureshi and colleagues conducted a randomized, double-blind, placebo-controlled trial to evaluate whether the addition of inhaled ipratropium decreased hospitalization rates in children who presented to the emergency department with an acute episode of asthma.. Children between the ages of two and 18 years who presented to the emergency department with an acute episode of asthma were eligible for the study. The severity of the asthma at presentation was classified according to the predicted peak expiratory flow rate. A peak expiratory flow rate of more than 70 percent was classified ...
Recommended for general use within NHS Scotland for the maintenance treatment of chronic obstructive pulmonary disease (COPD). RECOMMENDATION.. In clinical trials, tiotropium demonstrated superior efficacy to ipratropium and salmeterol in improving lung function (FEV1). Generally, it has greater efficacy than ipratropium, and similar efficacy to salmeterol in improving dyspnoea, the use of rescue medication, the frequency of COPD exacerbations and hospitalisation due to exacerbations.. ...
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7.1.6 Theophyllines Theophyllines have similar bronchodilator effects to beta-2 agonists. They improve quality of life, and the oral route of administration is an advantage for some patients.63 limitations include toxicity (particularly in the elderly), drug interactions and variable metabolism. The recommended dose of oral slow-release theophylline is 200 - 400 mg twice a day or 400 - 800 mg at night, and should not be exceeded without monitoring blood levels. Combination tablets containing theophylline and other bronchodilators or sedatives are not recommended. 7.1.7 Combination bronchodilator treatment A combination of bronchodilator agents is recommended and has additive effects. The following combinations are effective:64,65 SABA + ipratropium long-acting anti-cholinergic + SABA long-acting anti-cholinergic + LABA LABA + ipratropium. Oral theophylline may be added to any combination of inhaled treatment. 7.2 Inhaled corticosteroids Inhaled corticosteroids, particularly in combination with ...
Treatment Pharmacologic treatment of COPD is a long-term proposition. Effective agents reduce inflammation, improve pulmonary function and quality of life, and reduce the frequency of acute exacerbations. The authors of GOLD consider bronchodilators, such as the long-acting inhaled beta2 agonists salmeterol and formoterol, the foundation of therapy. These agents significantly improve symptoms, exercise capacity, and health status in patients with COPD.4,7,8 Anticholinergics, such as ipratropium bromide and tiotropium, are other first-line agents that can be used alone or in combination with long-acting or short-acting beta2 agonists. Once-daily tiotropium improves dyspnea in a magnitude similar to or greater than beta2 agonists.9-12 In patients with more severe COPD, bronchodilator therapy improves expiratory lung emptying and exercise tolerance.13,14 Both longacting beta2 agonists and long-acting anticholinergic agents also reduce exacerbation frequency.8,10-12 Clinicians prescribe ...
All patients must have a diagnosis of COPD (P06-12085), and must meet the following criteria: Relatively stable airway obstruction with a post-bronchodilator FEV1 ≤ 70% of predicted normal and post-bronchodilator FEV1 / FVC ≤70%.. Pulmonary function tests (PFTs) were conducted after the inhalation of 400 μg salbutamol / albuterol (preferred), however testing with either 200 μg salbutamol/albuterol or a combination of salbutamol / albuterol with ipratropium bromide (2 to 4 actuations) was acceptable. Other short-acting beta agonists, such as terbutaline, may have been used for the testing. The medication used for the testing was documented. Further, historical data from measurements within the past 6 months either at the site or at a referral site may have been used (see Section 6.2.1 of the CTP, located in Appendix 16.1.1). Subjects were not to have been randomized to the study without the availability of spirometry data at the actual study site.. Eligibility for PFT sub-study: For ...
This medicine is for use only in the nose. Follow the directions on the prescription label. Do not use more often than directed. Do not share this medicine with anyone else. Make sure that you are using your nasal spray correctly. Ask you doctor or health care provider if you have any questions.. Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children as young as 6 years of age for selected conditions, precautions do apply.. ...
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This trial compared the efficacy of the levosalbutamol given alone or in combination with ipratropium bromide. The primary outcome was bronchodilation.
We report a case of loss of diabetic control in a patient given high doses of inhaled fluticasone propionate for asthma.. A 67 year old man who had had asthma for 10 years was referred for respiratory assessment. He had had non-insulin dependent diabetes mellitus for 40 years and was taking glibenclamide 5 mg and metformin 1700 mg daily. Glycaemic control was monitored every six weeks in an outpatient clinic using the percentage of glycated haemoglobin (haemoglobin A1c) (Corning-Drew Glycomat low pressure chromatography system).1 The normal range is ,6% and the within batch coefficient of variation is 2.6% and 1.5% for concentrations of 7% and 10% respectively. During the previous year he had had only occasional trace glycosuria (,2 positive urinary glucose readings a week) and glycated haemoglobin concentrations (measured every 8 weeks) ranged from 7.0% to 7.3% (data not shown). His asthma treatment comprised ipratropium bromide 0.5 mg and salbutamol 5 mg by nebuliser four times daily. Computed ...
WASHINGTON - Dey Inc., Dey Pharma L.P. (formerly known as Dey, L.P.) and Dey L.P. Inc. have agreed to pay $280 million to settle False Claims Act allegations, the Department of Justice announced today. This settlement resolves claims by the United States that the defendants engaged in a scheme to report false and inflated prices for numerous pharmaceutical products, knowing that federal health care programs relied on those reported prices to set payment rates. The actual sales prices for the Dey products were far less than what Dey reported. The United States alleged that Dey reported false prices for the following drugs: Albuterol Sulfate, Albuterol MDI, Cromolyn Sodium and Ipratropium Bromide. The difference between the resulting inflated government payments and the actual price paid by health care providers for a drug is referred to as the spread. The larger the spread on a drug, the larger the profit for the health care provider or pharmacist who is reimbursed by the government. The ...
Tiotropium reduces the risk of exacerbations and hospitalisations compared with combined ipratropium/salbutamol in patients with COPD, a UK study concludes.
SABAs exhibit their therapeutic effects by lowering intracellular calcium concentrations, leading to relaxation of the smooth muscles in the airways.5 Albuterol products are racemic, 50:50 mixtures of the S and R isomers. The pure R isomer, which is sold as levalbuterol, has not proven superior to racemic albuterol.6 Caution should be used in patients with cardiac arrhythmia, as SABAs have been shown to cause tachycardia.. Epinephrine may be employed as an adjunct to treat severe exacerbations, but it is not recommended for routine use.3 SC terbutaline may also be used for such exacerbations, but with close monitoring.. Ipratropium is often employed as a reliever medication, either alone or in combination with albuterol. In adults, the albuterol combination has been shown to provide greater relief from acute exacerbations than albuterol alone. It may also be considered during emergency situations in which albuterol is not effective and when side effects of albuterol, such as tachycardia, must be ...
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TY - JOUR. T1 - How do climate-linked sex ratios and dispersal limit range boundaries?. AU - Boyle, Maria. AU - Schwanz, Lisa. AU - HONE, Jim. AU - GEORGES, Arthur. PY - 2014. Y1 - 2014. N2 - Background: Geographic ranges of ectotherms such as reptiles may be determined strongly by abiotic factors owing to causal links between ambient temperature, juvenile survival and individual sex (male or female). Unfortunately, we know little of how these factors interact with dispersal among populations across a species range. We used a simulation model to examine the effects of dispersal, temperature-dependent juvenile survival and sex determining mechanism (temperature-dependent sex determination (TSD) and genotypic sex determination (GSD)) and their interactions, on range limits in populations extending across a continuous range of air temperatures. In particular, we examined the relative importance of these parameters for population persistence to recommend targets for future empirical ...
Ipratropium is a short-acting muscarinic antagonist, which works by causing smooth muscles to relax. Ipratropium bromide was ... "Ipratropium - Drug Usage Statistics". ClinCalc. Retrieved 7 October 2022. Aaron, S. D. (2001). "The use of ipratropium bromide ... Ipratropium should never be used in place of salbutamol (albuterol) as a rescue medication. "Ipratropium Bromide". The American ... are clinically irrelevant when ipratropium is administered as an inhalant. Chemically, ipratropium bromide is a quaternary ...
Ipratropium nasal spray may reduce the symptoms of a runny nose but has little effect on stuffiness. Ipratropium may also help ... AlBalawi ZH, Othman SS, Alfaleh K (June 2013). "Intranasal ipratropium bromide for the common cold". The Cochrane Database of ...
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The two main anticholinergics used in COPD are ipratropium and tiotropium. Ipratropium is a short-acting muscarinic antagonist ... Cheyne L, Irvin-Sellers MJ, White J (September 2015). "Tiotropium versus ipratropium bromide for chronic obstructive pulmonary ... and tiotropium provides those benefits better than ipratropium. It does not appear to affect mortality or the overall ...
Some examples of anticholinergics are tiotropium (Spiriva) and ipratropium bromide.[citation needed] Tiotropium is a long- ... ipratropium bromide is used in the treatment of asthma and COPD. As a short-acting anticholinergic, it improves lung function ...
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