Atrovent for inhalation for children and adults

Bronchitis and bronchial asthma are quite common diseases of the respiratory system, the treatment of which rarely does without the use of drugs. One of the effective methods of treating infectious and inflammatory pathologies affecting the respiratory organs are inhalation procedures, which allow delivering drugs directly to the affected area (bronchi and lungs). But such treatment gives a good effect if you choose the right drug for the procedure, the effect of which will correspond to the patient's needs. If we are talking about increased sputum secretion and bronchial obstruction, doctors quite often prescribe "Atrovent" for inhalation - a drug with a bronchodilator effect.

[ 1 ]

Indications Atroventa for inhalation

So, we have already understood that the drug "Atrovent" is used exclusively for inhalations. But for what diseases can this procedure be prescribed?

The drug in the form of a solution, aerosol for inhalation for pathologies of the lower respiratory tract, capsules can be prescribed for:

• COPD. This abbreviation stands for chronic obstructive pulmonary disease, in which the air flow through the bronchi and lungs is insufficient for proper breathing.
• A particularly severe form of inflammation of the bronchi, occurring with obstruction (impaired patency) of the organ and called obstructive bronchitis.
• Emphysema of the lungs. This is a pathology in which pathological foci of expansion are detected in the bronchioles.
• Bronchial spasms due to various colds and infectious pathologies affecting the respiratory system, surgical procedures, exposure to cold air or tobacco smoke.
• Bronchial asthma. The drug is used to relieve attacks of the disease, occurring in a mild form. It can be used for moderate symptoms. Severe forms of the pathology should be treated with stronger drugs.
• Combination of bronchial asthma with cardiovascular pathologies.
• Increased production of sputum to relieve wet cough and prevent bronchial obstruction due to mucus accumulating in them.
• Conducting diagnostic procedures aimed at identifying the reversibility of obstructive processes in the bronchi and lungs, which is necessary both for making a diagnosis and for prognosticating the treatment of the pathology.
• Preparation for other inhalation procedures using antibiotics, mucolytics, corticosteroids. Bronchodilators, which include Atrovent, are always first on the list, as they prepare the bronchi for deep administration of other drugs.

An aerosol with a nasal nozzle is used mainly to treat chronic rhinitis (inflammation of the internal tissues of the nose, accompanied by mucous discharge). In this case, the drug facilitates breathing and prevents congestion in the nasal passages.

[ 2 ]

Release form

"Atrovent" is not one of the natural drugs that many patients treat with more favor, considering them the safest medicines. In the composition of the drug we find synthetic components:

• The main active ingredient is ipratropium bromide, known to many in connection with the popular drug for emergency aid for bronchial spasms and bronchial asthma called "Berodual". In the drug "Atrovent" this substance is included in the form of monohydrate.
• Additional components in the drug, depending on the form of release, may include:
  • Purified water, benzalkonium chloride as a preservative, stabilizer disodium edetate, sodium chloride, hydrochloric acid (for solution form)
  • prepared water, ethanol, citric acid, tetrafluoroethane as a propellant (for the aerosol composition).

In what forms of release can you find this frequently prescribed drug in pharmacies:

• Solution in dark glass bottles. Bottles with a dropper cap and a screw cap can have a volume of 20, 40 and 100 ml. 1 ml of the pharmacy solution contains 261 mcg of ipratropium bromide in the form of monohydrate (in terms of the anhydrous composition, this will be 250 mcg). The drug is intended for inhalation procedures.
• Aerosol in a metal bottle containing a mouthpiece and a dosing valve. The bottle volume can be 10 or 15 ml. The first contains 200 doses of the drug, the second - 300 doses. Each dose contains 20 mcg of the active substance. The aerosol is also used for inhalations that do not require additional equipment.
• Aerosol for inhalation for rhinitis (the drug is administered into the nasal cavity) with a nasal nozzle. Bottles may contain 10, 15, 20 and 30 ml, which corresponds to 200, 300, 400 and 600 doses.
• Capsules with ipratropium bromide powder, used for dry inhalation in special nebulizers. The package contains 100 capsules. Each capsule contains 200 mcg of the active substance.

The solution and composition in aerosols "Atrovent" for inhalation is a transparent uncolored liquid, in which there are no crystalline particles. The capsules contain a whitish fine powder.

Any form of release (aerosol, solution or drops, powder "Atrovent") can be used for inhalation. Aerosols are convenient because you can always take them with you to work or on a walk. And the solution can be used in nebulizers or centralized oxygen systems.

[ 3 ]

Pharmacodynamics

When purchasing the drug "Atrovent" for inhalation, a person will, of course, want to know what therapeutic effect the drug has and how long the effect of its use will last. The pharmacodynamics (mechanism of action) of the drug will help us answer the first question.

The manufacturers of the drug, and this is the German company BOEHRINGER INGELHEIM INTERNATIONAL, claim that their drug is an effective bronchodilator. What does this mean? Bronchodilators are drugs whose action consists in expanding the bronchi (bronchodilation) and relaxing the muscles of the organ (spasmolytic effect).

The combination of these two effects is due to the anticholinergic properties of the drug. Reflex bronchoconstriction may occur under the influence of various irritants (tobacco smoke, cold air, administration of drugs) or be caused by the reaction of the vagus nerve. By blocking the m-cholinergic receptors of the smooth muscles of the bronchi, the active substance of the drug reduces their tone and prevents airway obstruction.

Studies of the drug have shown that it has no negative effect on the production of bronchial secretions, gas exchange and mucociliary clearance. There is a slight decrease in the amount of sputum without inhibiting its discharge.

The drug has been used successfully to treat pathologies accompanied by bronchial spasms, such as viral bronchiolitis and bronchopulmonary dysplasia in young children, including infants.

[ 4 ]

Pharmacokinetics

Now let's talk about the pharmacokinetics of the drug, which may be interesting in that it tells how long the effect of inhalation of "Atrovent" can be observed and through which organs the drug is excreted from the body.

The drug "Atrovent" is intended for inhalation, so we should expect a local effect on the lesion from it. The absorption of the drug in the tissue is small. Usually no more than 30% of the active substance gets into the lungs, from where a small part of it still penetrates into the systemic bloodstream. The bulk of the drug settles in the oral cavity or gets into the gastrointestinal tract, where it is again absorbed in small quantities.

The drug is not able to penetrate the placental or blood-brain barrier, which indicates its relative safety.

It should be noted that pharmacokinetic parameters, which indicate the distribution of the drug in the body and its systemic effects, in this case do not affect the bronchodilatory properties of the drug.

The active substance is metabolized mainly in the liver. When administered by inhalation, about 70% of the active substance and its metabolites are excreted via the intestines. The kidneys excrete mainly inactive metabolites of ipratropium bromide.

Regardless of the concentration of the drug entering the blood, the effect of the medicine can be expected after 10-15 minutes, but it will reach maximum effectiveness only after 1-1.5 hours. On the one hand, this is a short waiting time, but if urgent help is needed, such a delay can cost a person his life. So the choice of a drug for emergency care should be stopped on other drugs.

The bronchodilator effect after inhalation can last for 5-6 hours, so repeated use of the drug should be carried out at intervals of 4-6 hours. Forty percent of patients experience a significant improvement in the functional capacity of the lungs (expiratory flow rate and volume of exhaled air).

[ 5 ], [ 6 ], [ 7 ]

Dosing and administration

The drug "Atrovent" for inhalation has a specific effect, so it is prescribed only in difficult situations when there is a risk of respiratory failure due to bronchial obstruction or spasm of the smooth muscles of the respiratory tract. The use of the drug for cough and bronchitis without obstruction is undesirable. In any case, treatment with "Atrovent" should be carried out under medical supervision. It is not for nothing that this strong drug can be purchased in pharmacies only with a prescription from a doctor.

The dosage of the drug for various diseases should be selected individually. In this case, the patient's condition, the severity of the pathology, the patient's age and the body's reaction to the active substance are taken into account.

Application of the aerosol "Atrovent" for inhalation. Before releasing the first dose of the drug into the throat, it is recommended to shake the inhaler bottle well. If the inhaler is new and this is its first use, you should first release a couple of doses into the air. The appearance of a specific cloud indicates that the spray is working properly and delivers the required therapeutic dose. If the medicine from a new bottle is released directly into the throat, the dosage may be insufficient due to the undeveloped dispenser and the effect will also be minimal, which is dangerous in case of bronchospasm.

If there has been a break in the use of the aerosol, particles deposited inside the dispenser may prevent the recommended dose from being dispensed. In this case, the first dose is also released into the air.

Aerosol can be used by patients over 6 years old. It is difficult for younger children to master all the intricacies of using this form of the drug. In addition, the inhalation of the drug in a high dosage (and each dose contains a standard 20 mcg of ipratropium bromide) can provoke bronchospasm in them.

The dosage for children and adults in this case will be approximately the same. Usually, patients are prescribed 2 injections of the drug (there should be an interval of at least one minute between them) 4 times a day. The maximum number of procedures per day is 12 (2 doses 6 times a day).

How to properly use an aerosol in the form of a bottle with a dispenser and mouthpiece:

• Before use, shake the can and remove the cap.
• Now let's try to slowly exhale the air completely.
• We turn the can upside down with the mouthpiece and grasp the tip with our lips.
• Take a deep breath and at the same time press the dispenser, releasing the first dose into your mouth.
• We hold our breath and remove the mouthpiece from our mouth.
• We take a slow breath out.
• After a minute, we repeat the procedure, introducing a second dose into the respiratory tract.

The canister should contain 200 or 300 doses. It may happen that the drug should have already run out by the number of doses, but there is a small volume of solution left in the bottle. It is not recommended to use the remaining medicine, since its pharmacological properties will already be much lower than those of the doses specified in the instructions. In this case, it is advisable to replace the canister with the drug. It will be very sad if the remaining medicine cannot relieve bronchial spasm or an asthma attack that is life-threatening.

To avoid any unexpected problems when using a pocket inhaler, you need to carefully monitor the cleanliness of the dispenser and mouthpiece. They can be washed with clean water or soap. In the latter case, it is necessary to rinse thoroughly with water.

A nasal inhaler for chronic rhinitis is usually used 3 times a day, introducing 2 or 3 doses of medicine into the nostril using a nasal nozzle each time. The procedure is done for both nasal passages.

Using the Atrovent solution for inhalation. When using the medicinal solution, it is necessary to take into account that each drop of the medicine contains 12.5 mcg of the active substance. And each milliliter consists of 20 such drops, i.e. contains 250 mcg of ipratropium bromide.

In the treatment of acute pathologies accompanied by sudden obstruction of the bronchi, the drug is used in the following dosages depending on the age and severity of the patient's condition:

• Patients over 12 years of age are usually prescribed 40 drops of Atrovent per procedure. A single dose of ipratropium bromide in this case will be 500 mcg.
• For children over 6 and under 12 years old, 1 ml (20 drops) is used per procedure. A single dose of the active substance in this case will be equal to 250 mcg.
• For the treatment of children under 6 years of age, the drug consumption will be from 8 to 20 drops per procedure (100-250 mcg).

The number of procedures per day and the intervals between them should be prescribed by the attending physician based on the severity of the disease and age indicators. It is permissible to use "Atrovent" together with beta-adrenergic agonists.

Maintenance therapy involves using the drug in the same doses, but the frequency of procedures will be no more than 4 per day, which allows not to exceed the maximum permissible daily doses, which for children under 12 years of age is 4 ml of solution, and for adults - 8 ml.

But that's not all. For inhalation procedures, ipratropium bromide solution is not used in its pure form. Inhalations are carried out with "Atrovent" and saline solution. That is, take the recommended dose of the drug, add saline solution (sodium chloride solution with a concentration of 0.9%) to it in the volume necessary to obtain 3.5-4 ml of the finished inhalation composition.

The most effective way to inhale is to use a nebulizer (any model will do). However, the dosage regimen in different devices may differ slightly, so you should first study the instructions for the nebulizer.

The duration of inhalations will depend on the patient's condition and the rate of consumption of the prepared liquid composition for inhalations. The preparations used in one solution for the procedure should be mixed immediately before inhalation. The solution remaining in the nebulizer is not suitable for the next procedure, so it should be drained into the sink and the device should be thoroughly rinsed.

The finished composition can be stored in the refrigerator for no more than a day. In this case, before pouring the solution into the inhaler, it is heated in a water bath to room temperature.

Use of capsules with powder for inhalation treatment. Dry inhalations with powder are carried out using a special inhaler with a mouthpiece attachment. In this case, particles of the drug enter the respiratory tract during a deep, sharp breath. Before placing the capsule in the inhaler, it must be pierced so that the particles of the drug are released gradually.

During inhalation, the mouthpiece of the inhaler should be in the patient's mouth. Before exhaling, hold your breath and remove the mouthpiece. The duration of the procedure is limited by the amount of powder in the capsule. As soon as it is finished, inhalation can be stopped. The frequency of procedures is normal - from 3 to 4 times a day.

[ 12 ]

Application for children

The drug "Atrovent", prescribed for inhalation in case of bronchial obstruction and bronchospasms, is considered a relatively safe drug, and the low absorption of its components in the body allows the drug to be used even for the treatment of small children without fear for the health and development of the baby.

According to the annotation to the medicine, "Atrovent" in aerosol is approved for use from the age of 6, and in solution - from the age of 5. But given the absence of dangerous effects of the drug for the child, it began to be used at an earlier age (mainly a solution for inhalation in nebulizers, which are effective and convenient for treating babies).

This somewhat contradicts the instructions, but the results of the studies show that the inhalation solution does not harm the child's body. On the contrary, in bronchial asthma with the production of a large amount of mucus in the bronchi (the so-called "wet asthma", often diagnosed in childhood), the drug helps to slightly reduce the amount of sputum and thus prevent it from blocking the bronchi, especially in children who do not yet know how to cough well.

"Atrovent" is a drug that does not have a negative effect on the cardiovascular system. In our difficult times, such pathologies increasingly make themselves known in early childhood. The use of "Atrovent" solution for inhalation in a nebulizer in the treatment of such children allows them to receive professional help in the treatment of asthma and obstructive bronchitis without worsening the condition of their heart.

However, there are some pathologies in which the drug should be used with special care and strictly under the supervision of a doctor. Such pathologies include chronic lung diseases, brain damage, Down's syndrome, cerebral palsy due to the risk of deterioration of the condition of such patients.

[ 13 ], [ 14 ]

Use Atroventa for inhalation during pregnancy

The use of the drug during pregnancy and lactation is not prohibited, because clinical studies with doses several times higher than safe ones have not shown a toxic effect of the drug on the fetus in the womb. No teratogenic effect on the developing organism has been identified, i.e. the drug is not capable of causing fetal developmental disorders.

And yet, medicine is medicine. Doctors are wary of prescribing the drug in the first trimester of pregnancy, when there is a high risk of miscarriage, and the main organs and systems of the child are in the formation stage. After all, each person's body (even a small embryo) is individual and it is difficult to predict its reaction to the drug.

In the following months, the prescription of Atrovent is based on the well-known principle of choosing the lesser of two evils, i.e. if there is a real threat to the mother’s life and there is no possibility of choosing an even safer drug.

As for breastfeeding, there is no information that ipratropium bromide can penetrate into breast milk. However, it would be safer, if possible, to refrain from breastfeeding the baby during treatment.

Contraindications

Although "Atrovent" for inhalation is considered a fairly safe drug, some restrictions on its use still exist. And although these restrictions are very few, they cannot be ignored.

The main contraindication for use, applicable to absolutely all drugs (synthetic and natural) is considered to be hypersensitivity to at least one of the main or auxiliary components. The drug is also not prescribed to those patients who have a history of an abnormal reaction to atropine and its derivatives, caused by individual intolerance.

The drug can be used, but with caution (preferably under the supervision of a doctor) in the following pathologies:

• closed-angle glaucoma, characterized by pathology of the iris in combination with high intraocular pressure,
• prostatic hyperplasia (excessive growth of prostate tissue),
• obstruction of the urinary tract caused by stenosis or diseases of the kidneys and bladder with the formation of stones (urolithiasis or nephrolithiasis).

[ 8 ], [ 9 ], [ 10 ]

Side effects Atroventa for inhalation

Since the drug "Atrovent" is used for inhalation, it is first of all worth mentioning the side effects directly related to the procedure. The smallest particles of the drug that a person inhales during inhalation procedures can slightly irritate the mucous membrane of the throat and bronchi, plus the bronchodilator effect promotes the removal of sputum, as a result of which a reflex cough may occur.

The use of inhaled bronchodilators can in rare cases provoke a reverse reaction in the form of bronchospasm. The drug "Atrovent" contains 2 components that cause such a reaction: the preservative benzalkonium chloride and the stabilizer disodium adeate.

The absorption of the drug into the blood is very low, so it does not cause serious systemic reactions. Most often, patients complain of headaches and dizziness, as well as the previously mentioned cough, throat irritation, dry mouth. Often, the drug provokes nausea and impaired gastrointestinal motility, caused by the entry of drug particles into the digestive system and the depressing effect on sensitive receptors.

Much less common are complaints of increased intraocular pressure and reversible vision problems, increased heart rate, swelling of the larynx and spasms of the respiratory tract, vomiting and bowel disorders. Mild allergic reactions in the form of swelling and hyperemia of tissues in the area of application, rash and itching on the skin may occur. Angioedema and anaphylactic reactions develop very rarely.

[ 11 ]

Overdose

Despite the fact that the drug "Atrovent" for inhalation is used locally, some readers may be concerned about such an unpleasant event as an overdose of the drug, which in severe cases, in the absence of timely assistance, can cost a person his life. Regarding the described drug, it can be said that there is no need to worry about this, because even that part of ipratropium bromide that gets into the lungs and intestines has low absorption.

Higher than recommended doses given intravenously (i.e. the drug goes directly into the bloodstream and can have a systemic effect) have not been shown to cause life-threatening symptoms, so inhalation treatment is unlikely to pose a risk of overdose.

The tenth part of the active substance, which usually penetrates into the lungs and blood, can only in rare cases cause dryness of the oral mucosa, minor reversible accommodation disorders and tachycardia (increased heart rate). In this case, symptomatic treatment is carried out. After the end of the use of "Antrovent", the functions of the organs are restored without consequences.

[ 15 ], [ 16 ]

Interactions with other drugs

The drug "Atrovent", used for inhalation in diseases of the upper and lower respiratory tract, is characterized by a strong anticholinergic effect. It can be combined with other drugs with a similar effect, but for a short time and under the supervision of a doctor, who, if necessary, will adjust the dose of drugs to avoid the development of various side effects.

The drug is considered a bronchodilator with sufficient effectiveness. But some types of drugs can further enhance its effect. We are talking about xanthine derivatives (the same theophylline) and beta-adrenergic agonists. The anticholinergic effect of "Atrovent" can be enhanced by drugs for the treatment of Parkinson's disease, quinidine, tricyclic antidepressants. When using such drugs together, you need to be careful. In this case, the dosage of the bronchodilator can be slightly reduced.

It is not recommended to combine the use of Atrovent and beta-adrenergic agonists in patients with closed-angle glaucoma. Such combined treatment may provoke an increase in intraocular pressure.

It is not advisable to use the described drug and cromoglycic acid simultaneously, since such a combination can reduce the effectiveness of both drugs.

It can be used as part of combined inhalations with mucolytics and expectorants (ambroxol, bromhexidine, etc.).

[ 17 ]

Storage conditions

Medicines of any form of release are packed in containers that protect the medicinal composition from sunlight, so additional protection is usually not required. The drug is not very sensitive to temperature conditions, which means it can be stored even at relatively high temperatures (up to 30 degrees). But the manufacturer does not recommend freezing the medicine.

[ 18 ]

Special instructions

It is not advisable to use "Atrovent" for inhalation for the purpose of providing emergency assistance during an asthma attack. If the drugs have the necessary effect faster, because in this case every minute counts.

When using a solution for inhalation in a nebulizer, you need to select the nozzles correctly. It is better if it is a mouthpiece or a mask selected strictly according to size, which will exclude unwanted ingress of drug particles into the eyes. The drug can cause not only eye irritation (pain, redness and swelling of the mucous membrane appear), but also some visual impairments (mydriasis, blurred vision, the appearance of multi-colored halos before the eyes, accommodation paresis, etc.), as well as increased intraocular pressure. Therefore, everyone needs to protect their eyes, and especially those who suffer from glaucoma.

If the above symptoms do appear (and they may indicate the development of glaucoma), you should consult a doctor to prescribe eye drops that relieve irritation and reduce intraocular pressure. Ideally, when prescribing this drug to patients, the doctor should warn them about such complications and explain how they can be avoided by using the drug in an aerosol or solution correctly.

Patients with urinary tract obstruction should use the drug strictly under the supervision of a doctor, because the drug may remain in their body longer than usual. In cystic fibrosis, there is a risk of decreased gastrointestinal motility, which also requires caution and monitoring of the patient's condition.

The aerosol preparation is available in freon-free and freon-containing forms, which differ slightly in taste but not in the effect they produce. Patients should also be warned about this.

Some side effects of the drug may be dangerous for patients whose activities require increased attention and concentration. Therefore, during the period of inhalation treatment, it is worth refraining from driving a car and performing potentially dangerous work.

[ 19 ], [ 20 ]

Shelf life

"Antrovent" can be used for inhalation during the expiration date indicated on the package, which is 3 years. After this period, the effectiveness of the drug decreases, but the risk of undesirable effects increases.

[ 21 ], [ 22 ]

Analogues

"Atrovent" is not the only drug with a bronchodilator effect that can be successfully used for inhalation in respiratory pathologies with the likelihood of developing airway obstruction or bronchospasm. Similar action is also characteristic of such drugs:

• "Ipravent" (is produced in the form of a compact aerosol with a metered dose of medicine),
• "Ipratropium" (available as a solution, also used in inhalation procedures),
• "Ipramol" (a drug in the form of an inhalation solution),
• "Spiriva" (a medicinal product available in capsules and as an inhalation solution),
• "Troventol" (a drug in an aerosol for inhalation in pathologies of the lower respiratory tract),
• "Truvent" (another aerosol with a bronchodilator effect),
• "Berodual" (a two-component drug in the form of an aerosol and a solution for inhalation).

We have listed similar in composition and action analogues of "Atrovent" for inhalation. Preparations with the same active ingredients are considered interchangeable, but you should also pay attention to the dosage of the drug and auxiliary components, the use of which the body can also respond with intolerance reactions. In any case, replacing one drug with another is desirable only with the permission of the attending physician.

The most popular analogue of "Atrovent" is considered to be "Berodual", which is often prescribed for bronchial obstruction and to relieve asthma attacks. In addition to ipratropium bromide (a substance with an atropine-like effect, which is designed to reduce the sensitivity of acetylcholine receptors to irritants that provoke bronchospasm), the drug contains another active substance. This is fenoterol hydrobromide, which helps to relax the smooth muscles of the bronchi and reduces the inflammatory process in the respiratory tract.

It is believed that such a dual action will give a stronger antispasmodic effect and act faster than the single-component "Atrovent". However, the presence of an additional antispasmodic component somewhat expands the list of pathologies in which the drug should be used with special caution due to the existing risk of complications.

During pregnancy, Atrovent will be even safer than Berodual. Antispasmodics can negatively affect the ability of the uterus to contract during labor, pushing the baby out, so in the last months of pregnancy, the choice will be in favor of Atrovent.

Reviews

Perhaps, "Atrovent" for inhalation in bronchial asthma, bronchial obstruction and pathologies with a high probability of developing bronchospasm is not prescribed as often as the popular "Berodual", however, this drug is not much inferior in effectiveness to its analogue.

Those who have tested the medicine on themselves or their relatives for the treatment of bronchial obstruction note that a significant improvement in the patient's condition occurs after 2 inhalations. And the effect is quite stable, so there is no need to use the drug often and for a long time.

Complex inhalation procedures give a good effect. "Atrovent" quickly and effectively increases the lumen of the bronchi, which facilitates the work of anti-inflammatory drugs, expectorants, mucolytics and antibiotics. Medicines are able to penetrate deep into the respiratory tract, reducing swelling and inflammation of the mucous membrane and removing phlegm from the bronchi with microbes hidden in it.

The drug is considered safe for treating children of any age and expectant mothers, which attracts even more attention from doctors and parents of sick children. Rapid relief of the child's symptoms cannot be unattractive to parents. Especially if the treatment does not lead to negative consequences for other organs of the baby, as is often the case with chemical drugs.

The drug is also suitable for preventing attacks of bronchial asthma. In this case, it is recommended to use it 1-2 hours before heavy physical exertion or events that can cause severe anxiety and an attack of suffocation. As an emergency aid, inhalations with "Atrovent" are best used in addition to drugs from the group of beta-adrenergic activators (for example, "Ventolin"). The effect will be stronger and will come faster, preventing organ hypoxia due to insufficient oxygen supply to the lungs.

Asthmatic patients note that long-term use of the drug, even with a high frequency of inhalations, did not lead to overdose or the occurrence of delayed side effects.

"Atrovent" for inhalation is a completely safe and convenient way to combat diseases that can provoke an asthma attack that is dangerous to a person's life. Convenient forms of release, affordable price and the possibility of treating adults, the elderly and children with the drug make the drug a very useful purchase. And yet, even the safest drugs should be used only with the permission of a qualified doctor, which will help to avoid unpleasant surprises.

[ 23 ], [ 24 ], [ 25 ]