Ipravent

Ipravent is an anti-asthma medication that is used by inhalation.

Its active ingredient is ipratropium bromide, which is a competitive antagonist of the acetylcholine neuromediator. Ipratropium bromide is a 4-type ammonium ligament with an anticholinergic (parasympatholytic) effect. The drug slows down vagal reflex actions by antagonistically interacting with acetylcholine (a mediator that ensures the movement of neuronal impulses in the vagus nerve). [1]

Indications Ipravent

It is used for long- term therapy of reverse bronchial spasm caused by chronic asthma or chronic obstructive disorders.

Release form

The drug is released in the form of an inhalation (metered) aerosol (volume - 200 portions per container). The box contains 1 such container with a spray tip and a dosing valve.

Pharmacodynamics

Ipratropium bromide blocks the action of the muscarinic endings of the smooth muscles of the tracheobronchial trunk, and also inhibits the process of reflex narrowing of the bronchi. Cholinolytic substances prevent an increase in intracellular parameters of the cGMP element, which develops during the interaction of acetylcholine and muscarinic endings of smooth muscles.

The drug prevents acetylcholine-related stimulation directed at sensory fibers in the vagus nerve, under the influence of various factors. This property of drugs is noted both before the onset of exposure to negative factors, and in the case of an existing process. As a result, the medication demonstrates intense bronchodilator and prophylactic activity. [2]

Ipravent weakens the excretory function of the glands of the bronchi and nasal mucosa. [3]

In persons with bronchial spasm caused by chronic pulmonary obstruction (pulmonary emphysema or chronic bronchitis), the use of ipratropium bromide leads to a significant improvement in pulmonary activity 15 minutes after the injection of drugs.

The maximum bronchodilator effect of the drug develops at the end of the 1st hour after application and lasts for a period of 5-6 hours (on average). Bronchodilation after inhalation of ipratropium bromide is mainly associated with the local specific activity of the drug.

There was no negative effect of ipratropium bromide in relation to mucus secretion within the respiratory tract, gas exchange and mucociliary clearance.

Pharmacokinetics

The drug effect of the drug develops with the manifestation of a local effect relative to the respiratory tract. Bioavailability values for oral administration of drugs are only about 2%.

The term for the elimination half-life is approximately 1.6 hours. The systemic clearance of the active element is 2.3 liters per minute. About 40% of the clearance is 0.9 liters per minute, and another 60% are nonrenal (mainly hepatometabolic). The main metabolic elements determined inside the urine are poorly synthesized with the endings of muscarin.

Excretion of the unchanged active ingredient through the kidneys is equal to 4.4-13.1% of the portion for oral inhalation.

Less than 20% of the drug is synthesized with protein. The active element is not accumulated; the drug does not overcome the BBB.

Dosing and administration

Persons over 12 years old and adults need to consume 40 mcg (1 inhalation procedure) 3-4 times a day. Sometimes, to obtain the highest effect in an adult, at the initial stage of therapy, you can increase the dose to 80 μg (2 inhalations) with 3-4 times a day.

Children 6-12 years of age are given 1 inhalation (40 mcg) 3 times a day. The child can use the aerosol only under the supervision of adults and with the appointment of a doctor.

In the absence of a medicinal effect from the introduction of drugs or a deterioration in the clinical condition, or in the case of a significant weakening of the effectiveness of the dosage used, it is necessary to consult a physician regarding further actions. In case of sudden onset of dyspnea, an urgent need to consult a doctor.

The duration of the treatment cycle is determined by the severity of the course of the disease and is selected personally. A spacer is used for inhalation.

Shake the container and press the dosing valve 1-2 times before using the aerosol.

• Application for children

The 40 mcg dosage should not be used in children under 6 years of age.

Use Ipravent during pregnancy

There is no information regarding the safety of using Ipraventa during pregnancy. The medicine is not prescribed in the 1st trimester. In the 2nd and 3rd trimesters, it can be used only in situations where the likely benefits for the woman are more expected than the risks of complications for the fetus.

Ipratropium bromide can be excreted in breast milk, which is why it is not used during breastfeeding.

Contraindications

Among the contraindications:

• obstructive form of hypertrophic cardiomyopathy;
• tachyarrhythmia;
• severe intolerance to atropine-like elements and other components of the drug.

Side effects Ipravent

The main side effects:

• disorders associated with digestive activity: gustatory disorder, vomiting, xerostomia, gastrointestinal motility disorder (constipation or diarrhea) and nausea;
• problems with the function of the CVS: extrasystole or palpitations. Occasionally, atrial fibrillation or supraventricular tachycardia is observed;
• disorders affecting the respiratory tract: increased viscosity of sputum, pain and irritation in the throat, laryngospasm, cough and paradoxical bronchial spasm;
• lesions in the NS area: tremor of the skeletal muscles, headaches, nervousness and dizziness;
• epidermal symptoms: itching, epidermal rash and weakening of the secretory function of the sweat glands;
• violation of visual function: if drugs get into the eyes, accommodation disorders, conjunctivitis, visual blurriness and pain in the eye area may appear, as well as dilation of the eye pupils and an increase in the level of IOP (in persons with angle-closure glaucoma);
• manifestations of allergies: MEE, anaphylaxis, urticaria and Quincke's edema in the area of the lips, tongue and face;
• disorders of urinary activity: impaired urination (especially in persons with prostatic hyperplasia) or its delay.

Overdose

Among the identified cases of poisoning - reversible accommodation disorder, increased heart rate and xerostomia.

Interactions with other drugs

In the case of a combination with Ipravent, there is an increase in the bronchodilator activity of xanthine derivatives (for example, theophylline) and β-adrenomimetics; in addition, the effect of substances demonstrating anticholinergic effects can be potentiated.

The combination with β-adrenergic agonists penetrating into the circulatory system, xanthine derivatives (for example, theophylline) and cholinolytic substances can potentiate the side symptoms of drugs.

The use together with antiparkinsonian drugs, tricyclics and quinidine leads to an increase in the anticholinergic properties of the drug.

Storage conditions

Ipravent should be kept out of the reach of children. Temperature values - no more than 30 ° C. Do not freeze the medicine.

Shelf life

Ipravent is allowed to be used within 24 months from the date of sale of the medicinal substance.

Analogs

The analogs of the drug are the medicines Zikomb, Berodual with Freeway combi, Duolin with Otrivin Extra, and also Ipradual with Xymelin Extra.