Name of Drug Classification Mechanism of Action Indication Contraindication Side Effects Nursing Responsibilities

Generic Name: Pharmacologic Class: Ipratropium bromide is an General Indications: Hypersensitivity to CNS: dizziness,blurred vision Before
Salbutamol + Anitcholinergic anticholinergic - patients with chronic salbutamol, ipratropium 1. Check the doctor’s order
Ipratropium (parasympatholytic) agent obstructive pulmonary or fenoterol, atropine or GI: nausea, drymouth 2. Assess allergy to the drug
which, based on animal disease (COPD) on a its 3. Caution patient of the
Trade/Brand Name: studies, appears to inhibit regular aerosol derivatives.Hypertrophic Respi: different side effects
Combivent, DuoNeb, vagally-mediated reflexes bronchodilator who obstructive dyspnea,bronchospasms,horsenes 4. Obtain baseline vital
Breva Therapeutic Class: by antagonizing the action continue to have cardiomyopathy, s signs
Bronchodilator of acetylcholine, the evidence of tachyarrhythmia. 5. Prepare drugs properly at
Patients’ Dose: transmitter agent released bronchospasm and who CV: palpitations,chest pain the right dosage.
at the neuromuscular require a second Drug to Drug
junctions in the lung. bronchodilator. Interactions:Increased
Route: Anticholinergics prevent adverse effects with During
Inhalation the increases in corticosteroids, xanthine 1. Verify patient’s identity
Pregnancy Category: intracellular concentration derivatives, diuretics. 2. Explain to patient the
Form: C of Ca++ which is caused purpose of medication
by interaction of Special Precaution: 3. Advise patient to swallow
acetylcholine with the Patient’s Indication: Patient with CV medication as a whole
Maximum dose: muscarinic receptors on disorders (e.g. ischaemic 4. Give drug with full glass
<6 times/24 hours bronchial smooth muscle. heart disease, arrhythmia, of water to reduce risk of
severe heart failure), tablet or capsule lodging in
Salbutamol relaxes severe airway the esophagus.
Minimum dose: bronchial, uterine, and obstruction, cystic 5.Do not crush, and ensure
4 times/24 hours vascular smooth muscle by fibrosis, prostatic that patient does not chew
stimulating beta 2 hyperplasia or bladder- SR preparations.
receptors. neck obstruction,
Availability: convulsive disorders,
Inhalation Solution hyperthyroidism, After
Pharmacokinetics diabetes mellitus. 1. Monitor vital signs noting
Absorption: Ipratropium: Pregnancy and lactation. hypotension andan irregular
Content: Rapidly absorbed after orabnormal pulse.
Albuterol Sulfate 2.5 mg inhalation. Bioavailability: 2. Monitor for adverse
in 3mL <10%; Salbutamol: effects.
Ipratropium Bromide 0.5 Rapidly and completely 3. Maintain aquiet,
mg in 3mL absorbed after inhalation. comfortableenvironment
Time to peak plasma tominimize anxietyand
concentration: Within 3 perhapsdecreasepalpitations.
hours. 4. Document correctly and
 Distribution: Ipratropium: accordingly.
Plasma protein binding:
<20%.
Metabolism: Ipratropium:
Partially metabolised to
inactive ester hydrolysis
products; Salbutamol:
Undergoes first-pass
metabolism in the liver
and possibly in the gut
wall. Metabolised to
inactive sulfate conjugate.
Excretion: Ipratropium:
Via urine and faeces.
Terminal elimination half-
life: 1.6 hours.
Salbutamol: Via urine (as
metabolites and
unchanged drug); faeces
(small amounts).
Elimination half-life: 3-7
hours.

Half life:
- Salbutamol: 4 hr;
Ipratropium: 2 hr
Peak:
- Salbutamol: 2-3 hr;
Ipratropium: 1-2 hr
Onset:
- Salbutamol: 15-30
minutes; Ipratropium: 5-15
minutes
Duration
-- Salbutamol: 4-8 hr;
Ipratropium: 3-6 hr

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Lippincott, Williams & Lippincott, Williams & Lippincott, Williams & Lippincott, Williams & Lippincott, Williams & Lippincott, Williams &
Wilkins Wilkins Wilkins Wilkins Wilkins JONES & BARTLETT Wilkins
LEARNING. (2018). Nurses
JONES & BARTLETT JONES & BARTLETT JONES & BARTLETT JONES & BARTLETT JONES & BARTLETT Drug Handbook. SUDBURY. JONES & BARTLETT
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Nurses Drug Handbook. Nurses Drug Handbook. Nurses Drug Handbook. Nurses Drug Handbook. Nurses Drug Handbook. Nurses Drug Handbook.
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