Anticholinergics
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
Ipratropium is the most common anticholinergic used for respiratory disorders.
Pharmacokinetics
Anticholinergics are minimally absorbed from the GI tract; they come in inhaled forms that exert their effects locally.
Pharmacodynamics
Ipratropium inhibits muscarinic receptors, which results in bronchodilation. This drug works by blocking the parasympathetic nervous system, rather than stimulating the sympathetic nervous system.
Pharmacotherapeutics
Anticholinergics are used to relieve symptoms in the patient with COPD. They’re less effective in long-term management of the patient with asthma; however, they may be used as adjunctive therapy (usually in combination with a short-acting beta2-adrenergic agonist on a scheduled basis).
Drug interactions
Interactions are uncommon when using the inhaled forms. Ipratropium should be used cautiously with antimuscarinic drugs and other anticholinergics.
Warning!
Adverse reactions to anticholinergics
The most common adverse reactions to anticholinergics include:
- nervousness
- tachycardia
- nausea and vomiting
- paradoxical bronchospasm (with excessive use)
- dry mouth.
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