What is the role of ipratropium bromide (Atrovent) in the treatment of status asthmaticus?

Updated: Jun 17, 2020
  • Author: Constantine K Saadeh, MD; Chief Editor: John J Oppenheimer, MD  more...
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Ipratropium bromide (Atrovent), a quaternary amine that does not cross the blood-brain barrier, is the recommended anticholenergic parasympatholytic agent of choice. This synthetic ammonium compound is very similar structurally to atropine. It comes in premixed vials at 0.2%, is administered every 4-6 hours, and can be synergistic with albuterol or other beta2-agonists when treating severe acute asthma exacerbations.

Ipratropium may also be used as an alternative bronchodilator in patients who are unable to tolerate inhaled beta2-agonists. Because children appear to have more cholinergic receptors, they are more responsive to parasympathetic stimulation than adults.

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