Ipratropium

Systematic (IUPAC) name
[8-methyl-8-(1-methylethyl)- 8-azoniabicyclo[3.2.1] oct-3-yl] 3-hydroxy-2-phenyl-propanoate
Identifiers
CAS number	60205-81-4
ATC code	R01AX03 R03BB01
PubChem	43232
DrugBank	APRD00537
Chemical data
Formula	C20H30NO3
Mol. mass	332.457 g/mol
SMILES	eMolecules & PubChem
Pharmacokinetic data
Bioavailability	?
Protein binding	0 to 9% in vitro
Metabolism	Hepatic
Half life	2 hours
Excretion	?
Therapeutic considerations
Pregnancy cat.	B(US)
Legal status	POM(UK)
Routes	Inhalation
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Ipratropium (as ipratropium bromide, trade name Atrovent and Apovent^[1]) is an anticholinergic drug.^[2]

[edit] Uses

It is administered by inhalation for the treatment of obstructive lung diseases.

Ipratropium is also combined with albuterol (salbutamol) (trade names Combivent and Duoneb, in Italy known as Breva) for the management of chronic obstructive pulmonary disease (COPD) and asthma.

Ipratropium is also combined with fenoterol (trade names Duovent and Berodual N) for the management of asthma.

Ipratropium can reduce rhinorrhea but will not help nasal congestion.

[edit] Pharmacology

It blocks muscarinic cholinergic receptors, without specificity for subtypes, resulting in a decrease in the formation of cyclic guanosine monophosphate (cGMP). 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 non-selective 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 prevents central side-effects (anticholinergic syndrome). Ipratropium is considered a short-acting bronchodilator.^[4][5]

[edit] Side effects

If ipratropium is inhaled, side-effects resembling those of other anticholinergics are minimal. However, dry mouth and sedation have been reported. Also effects such as skin flushing, tachycardia, acute angle ocular dislocure, nausea, palpitations and headache have been observed.

[edit] References