From the Guidelines
Ipratropium bromide does not harden secretions in the lungs. As an anticholinergic bronchodilator, ipratropium works by blocking muscarinic receptors in the airways, which relaxes bronchial smooth muscle and improves airflow. Unlike some medications, ipratropium actually has minimal effects on mucus viscosity or production. It may cause some dryness of the mouth as a side effect, but this does not translate to hardening of lung secretions. This is why ipratropium (commonly available as Atrovent, typically dosed at 2-4 puffs every 4-6 hours) can be safely used in patients with COPD or asthma who have mucus production. In fact, by improving airflow and bronchodilation, ipratropium may indirectly help patients clear secretions more effectively through improved coughing mechanics. This differs from medications like antihistamines or some decongestants, which can potentially thicken secretions. Patients using ipratropium should still maintain adequate hydration to help keep secretions manageable, but they need not worry about the medication itself causing secretions to harden.
Key Points
- Ipratropium bromide is an anticholinergic bronchodilator that improves airflow and bronchodilation
- It has minimal effects on mucus viscosity or production
- It can be safely used in patients with COPD or asthma who have mucus production
- Patients should maintain adequate hydration to help keep secretions manageable
According to the study by 1, ipratropium bromide has been shown to suppress subjective measures of cough in patients with URI or chronic bronchitis. Additionally, the study by 1 recommends the use of ipratropium bromide to improve cough in stable patients with chronic bronchitis. Overall, the evidence suggests that ipratropium bromide is a safe and effective treatment option for patients with COPD or asthma who have mucus production, and it does not harden secretions in the lungs.
From the Research
Ipratropium Bromide and Lung Secretions
- The effect of ipratropium bromide on mucociliary clearance rate and airway resistance in normal subjects was investigated in a study published in 1977 2.
- The study found that ipratropium bromide did not significantly affect the rate of clearance of secretions from the lung, but it did result in statistically significant falls in specific airway resistance.
- There is no evidence to suggest that ipratropium bromide hardens secretions in the lung, but rather it may help to reduce airway resistance and improve bronchodilation.
Mechanism of Action
- Ipratropium bromide is an anticholinergic bronchodilator that interrupts vagally mediated bronchoconstriction by inhibiting the cyclic guanosine 3',5'-monophosphate system at parasympathetic nerve endings 3.
- It is poorly absorbed after oral and inhaled administration, but diffuses rapidly into tissue after intravenous or intramuscular administration 3.
- The elimination half-life of ipratropium bromide is 3.2-3.8 hours, and it is eliminated in the urine and feces after inhalation 3.
Clinical Efficacy
- Ipratropium bromide has been shown to be effective in the treatment of chronic obstructive pulmonary disease (COPD) and asthma, with a bronchodilatory effect comparable to or superior to that of beta-sympathomimetic agents 3, 4, 5.
- It may be a useful adjunctive agent in the treatment of asthma, but should not be used as single-drug therapy in an acute asthmatic exacerbation due to its delayed onset of action 3, 4.