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SAMA·Respiratory - Asthma & COPD
Acute asthma (severe), COPD maintenance and exacerbations
Max Dose
2000 mcg/day
Half-life
2 h
Glaucoma
AVOID SPRAY
Dry Mouth
COMMON
Overview
Short-Acting Muscarinic Antagonist (SAMA). An anticholinergic bronchodilator. Acts purely locally in the airways to dry secretions and block vagal bronchoconstriction.
Maximum Dose
Max 2000 mcg/day (via nebuliser).
Clinical Focus
Escaping nebuliser mist hitting the eyes can precipitate acute angle-closure glaucoma.
Bottom Line
Ipratropium is a short-acting anticholinergic bronchodilator essential in acute severe asthma (with salbutamol) and COPD, but has slower onset than salbutamol and is not a standalone reliever.
Brand Names
Atrovent, Combivent (combo)
Oral Routes
Metered Dose Inhaler (21 mcg/actuation). Nebules (250 mcg/1 mL, 500 mcg/1 mL).
Prescribing & PBS
Unrestricted General Benefit (S4).
Primary
Acute asthma (severe), COPD maintenance and exacerbations.
Clinical Place
Added to SABA therapy for the first 24-48 hours of severe asthma/COPD exacerbations. Rarely used long-term anymore due to superiority of LAMAs (e.g., Tiotropium).