Inhaled ipratropium, an anticholinergic, is a bronchodilator used primarily in the patient suffering from COPD, but it may also be used as an adjunct to beta2-adrenergic agonists.
Ipratropium is the most common anticholinergic used for respira-tory disorders.
Anticholinergics are minimally absorbed from the GI tract; they come in inhaled forms that exert their effects locally.
Ipratropium inhibits muscarinic receptors, which results in bron-chodilation. This drug works by blocking the parasympathetic ner-vous system, rather than stimulating the sympathetic nervous sys-tem.
Anticholinergics are used to relieve symptoms in the patient with COPD. They’re less effective in long-term management of the pa-tient with asthma; however, they may be used as adjunctive thera-py (usually in combination with a short-acting beta2-adrenergic ag-onist on a scheduled basis).
Interactions are uncommon when using the inhaled forms. Ipratropium should be used cautiously with antimuscarinic drugsand other anticholinergics. (See Adverse reactions to anticholinergics.)