Atrovent & Solu-Medrol

ipratropium bromide

Atrovent

• Parasympatholytic
• Anticholinergic
• Bronchodilator

• Competitive agonist to acetylcholine at muscarinic receptor sites
•      Blocks parasympathetic response and allows sympathetic response to take over
•           Lungs:
•                 Decreased mucous production
•                 Increased bronchial smooth muscle relaxation
•      

• Bronchospams secondary to:
•      Asthma
•      Chronic bronchitis
•      Emphysema

• Why?
• Decreased mucous production & increased bronchial smooth muscle relaxation increases bronchial airway diameter

All dosages via oxygen powered small volume nebulizer (SVN) with mouthpeice, facemask or in-line BVM.  Atrovent usually mixed with Albuterol in pre-hospital setting. 

• Adult:
• Atrovent 0.5mg premixed solution added to 2.5mg albuterol via SVN, repeated per agency protocol

• Known hypersensitivity / allergy to drug or Atropine
• Acute narrow angle glaucoma (relative)
•      (Painful glaucoma probably acute narrow angle type)

Usually added to Albuterol since Atrovent more effective in dilation of larger central airways and Albuterol more effective in dilation of smaller peripheral airways.  

• Tachycardia
• Tremors
• Agitation/ Nervousness / Anxiety
• Nausea / Vomiting

5 - 15 minutes

4 x 0.5mg Atrovent in 2.5cc NS premixed plastic bottles (bullets), sulfite free

methylpredisolone sodium succinate

Solu-Medrol

• Corticosteroid
• Anti-Inflammatory

• Intracellular agonist
•      Immunosuppressant
•           Reduces inflammation
•           Thought to stabilize cell membranes

• Bronchospasm
•      Asthma
•      Chronic bronchitis
•      Emphysema

Anaphylaxis

• Why?
• Reduces inflamation and supresses the immune system

All doses via slow IV push

• Adult:
• Solu-Medrol 125mg slow IV push

• Known hypersensitivity / allergy
• Cushing's syndrome
• Use caution in patients with active infections

None

None for single dose

Hours

1 x 125mg in 2cc mix-a-vial