Ipratropium

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Ipratropium
Systematic (IUPAC) name
[8-methyl-8-(1-methylethyl)- 8-azoniabicyclo[3.2.1] oct-3-yl] 3-hydroxy-2-phenyl-propanoate
Identifiers
CAS number	60205-81-4
ATC code	R01AX03 R03BB01
PubChem	43232
DrugBank	APRD00537
Chemical data
Formula	C20H30NO3
Mol. mass	332.457 g/mol
SMILES	eMolecules & PubChem
Pharmacokinetic data
Bioavailability	?
Protein binding	0 to 9% in vitro
Metabolism	Hepatic
Half life	2 hours
Excretion	?
Therapeutic considerations
Pregnancy cat.	B(US)
Legal status	POM(UK)
Routes	Inhalation

Ipratropium (as ipratropium bromide, trade name Atrovent and Apovent^[1]) is an anticholinergic drug.^[2]

Contents 1 Uses 2 Pharmacology 3 Side effects 4 References

[edit] Uses

It is administered by inhalation for the treatment of obstructive lung diseases.

Ipratropium is also combined with albuterol (salbutamol) (trade names Combivent and Duoneb) for the management of chronic obstructive pulmonary disease (COPD) and asthma.

Ipratropium is also combined with fenoterol (trade names Duovent and Berodual N) for the management of asthma.

[edit] Pharmacology

It acts by blocking muscarinic receptors in the lung, inhibiting bronchoconstriction and mucus secretion. It is a non-selective muscarinic antagonist, and does not diffuse into the blood, which prevents systemic side-effects. Ipratropium is a derivative of atropine^[3] but is a quaternary amine and therefore does not cross the blood-brain barrier, which prevents central side-effects (anticholinergic syndrome). Ipratropium is considered a short-acting bronchodilator.^[4][5]

[edit] Side effects

If ipratropium is inhaled, side-effects resembling those of other anticholinergics are minimal. However, dry mouth and sedation have been reported.

[edit] References

v • d • e Anticholinergics Nicotinic antagonists Ganglionic nondepolarizing: Hexamethonium, Mecamylamine, Pentolinium, Trimetaphan depolarizing: Nicotine (high doses) note: in PNS, ganglionic blocker can have direct antinicotinic action at preganglionic terminal, but simulate indirect antimuscarinic activities at postganglionic terminal Neuromuscular Non-depolarising Curare alkaloids Alcuronium · Dimethyltubocurarine · Tubocurarine 4° ammonium short duration: Mivacurium intermediate: Atracurium/Cisatracurium · Fazadinium · Rocuronium (short onset) · Vecuronium long: Doxacurium · Metocurine · Pancuronium · Pipecuronium unsorted: Gallamine · Hexafluronium Depolarising choline derivatives (Suxamethonium, Succinylcholine) · Decamethonium Muscarinic antagonists nonpolar/tertiary/CNS: Atropine · Scopolamine · Hyoscyamine · antiparkinson drugs (Benzatropine, Trihexyphenidyl, Biperiden) polar/quarternary/non-CNS: Glycopyrrolate · Ipratropium · M1 (Pirenzepine, Telenzepine) · M3 (Tiotropium, Darifenacin, Vedaclidine) unsorted: Tropicamide · Cyclopentolate · Dicycloverine · Tolterodine · Oxybutynin · Homatropine  · Orphenadrine · Diphenhydramine · Other ethanolamine class first-generation antihistamines Indirect acetylcholine synthesis inhibitor (Hemicholinium-3) · vesicle storage inhibitor (Vesamicol) · acetylcholine release inhibitor (Botulinum toxin) · acetylcholine release stimulator (Alpha-latrotoxin) · acetylcholinesterase reactivators (Pralidoxime, Obidoxime)

v • d • e Decongestants and other nasal preparations (R01) Topical Sympathomimetics, plain Cyclopentamine • Ephedrine • Phenylephrine • Oxymetazoline • Tetryzoline • Xylometazoline • Naphazoline • Tramazoline • Metizoline • Tuaminoheptane • Fenoxazoline • Tymazoline • Epinephrine Antiallergic agents, excluding corticosteroids Spaglumic acid histamine antagonists (Levocabastine, Antazoline, Thonzylamine) mast cell stabilizer (some are also antihistamines) (Cromoglicic acid, Nedocromil, Azelastine, Olopatadine) Corticosteroids Beclometasone • Prednisolone • Dexamethasone • Flunisolide • Budesonide • Betamethasone • Tixocortol • Fluticasone • Mometasone furoate • Triamcinolone • Ciclesonide Other nasal preparations Calcium hexamine thiocyanate • Retinol • Ipratropium bromide • Ritiometan • Mupirocin • Hexamidine • Framycetin • Hyaluronic acid • Eucalyptus oil Systemic use: Sympathomimetics Phenylpropanolamine • Pseudoephedrine • Phenylephrine • Phenylpropylamine

v • d • e Drugs for obstructive airway diseases: asthma/COPD (R03) Adrenergics, inhalants Short acting β2-agonists Salbutamol/Levosalbutamol • Fenoterol • Terbutaline • Pirbuterol • Procaterol • Bitolterol • Rimiterol • Carbuterol • Tulobuterol • Reproterol Long acting β2-agonists (LABA) Arformoterol • Bambuterol • Clenbuterol • Formoterol • Salmeterol Ultra LABA: Indacaterol other Epinephrine • Hexoprenaline • Isoprenaline (Isoproterenol) • Orciprenaline (Metaproterenol) Glucocorticoids Beclometasone • Budesonide • Ciclesonide • Fluticasone • Mometasone Anticholinergics/ muscarinic antagonist Ipratropium • Tiotropium Mast cell stabilizers Cromoglicate • Nedocromil Xanthines Doxofylline • Theobromine • Theophylline/Aminophylline Eicosanoid inhibition Leukotriene antagonists Montelukast • Pranlukast • Zafirlukast Lipoxygenase inhibitor Zileuton Thromboxane receptor antagonists Ramatroban • Seratrodast Combination products Budesonide/formoterol • Fluticasone/salmeterol • Ipratropium/salbutamol

http://en.wikipedia.org/wiki/Ipratropium