Anticholinergics
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.)
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