From the Guidelines
Yes, Atrovent (Ipratropium) is an anticholinergic medication. It works by blocking the action of acetylcholine, a neurotransmitter that causes bronchial smooth muscle contraction. By inhibiting these muscarinic receptors in the airways, Atrovent helps relax and open the bronchial passages, making breathing easier. According to a study published in the European Respiratory Journal 1, anticholinergic agents, including ipratropium, are more effective in COPD than in asthma.
Key Characteristics of Atrovent
- Available as an inhaler (typically 2 puffs 4 times daily) or as a nebulizer solution (500 mcg every 6-8 hours)
- Slower onset of action (15-30 minutes) but provides relief for 4-6 hours
- Primarily affects the airways with minimal systemic absorption, resulting in fewer side effects than oral anticholinergics
- Common side effects include dry mouth, throat irritation, and occasionally headache
Clinical Use
Atrovent is commonly used to treat chronic obstructive pulmonary disease (COPD) and sometimes asthma. It is often used alongside beta-agonist bronchodilators like albuterol for more comprehensive symptom management in respiratory conditions. A study published in the Annals of Internal Medicine 1 found that ipratropium, a short-acting anticholinergic, was not superior to placebo in reducing exacerbations, but tiotropium, a long-acting anticholinergic, was more effective than ipratropium in reducing exacerbations.
Comparison with Other Treatments
- Long-acting β-agonists were as effective in reducing exacerbations as ipratropium 1
- Tiotropium was more effective than ipratropium in reducing exacerbations 1
- A meta-analysis found a 73% relative reduction in mortality associated with anticholinergics compared with placebo 1
From the FDA Drug Label
Ipratropium bromide is an anticholinergic (parasympatholytic) agent that, based on animal studies, appears to inhibit vagally-mediated reflexes by antagonizing the action of acetylcholine, the transmitter agent released from the vagus nerve It is a synthetic quaternary ammonium compound, chemically related to atropine.
Yes, Atrovent (Ipratropium) is an anticholinergic 2 2.
From the Research
Definition and Classification of Atrovent (Ipratropium)
- Atrovent, also known as Ipratropium, is classified as an anticholinergic bronchodilator 3, 4, 5, 6, 7.
- It acts by inhibiting the action of acetylcholine at muscarinic receptors in the lungs, resulting in bronchodilation 4, 5, 6, 7.
Mechanism of Action and Therapeutic Effects
- Ipratropium bromide is administered by inhalation and produces bronchodilation in patients with obstructive airways disease 3.
- It is somewhat less effective than beta 2-adrenoceptor agonist drugs in patients with asthma, but is at least as effective as these agents in bronchitis 3.
- The onset of maximum effect with ipratropium is slower than with isoprenaline, but the duration of effect is longer 3.
Comparison with Other Anticholinergic Agents
- Ipratropium bromide is a short-acting anticholinergic agent, whereas tiotropium bromide is a long-acting antimuscarinic agent (LAMA) 4, 5.
- Tiotropium has a longer duration of action than ipratropium, allowing for once-daily dosing 5.
- Newer LAMAs, such as aclidinium bromide and glycopyrrolate bromide, are currently in development for the treatment of COPD 4.