Albuterol and Ipratropium

Published

I am currently in a pediatric med-surg class and my professor is an ER nurse. She told us that for an emergent pediatric asthma patient, a dose of Albuterol is given and then Ipratropium. However, only one dose of Ipratropium can be given and then Albuterol is administered again. Why is this?

The only thing I am finding is the medications have the potential to cause paradoxial bronchospasms and hypoglecmia. I feel this is more of a side effect of the two medications as opposed to a potential interaction between the two medications.

I was hoping someone knew why only one dose of Ipratropium can be administered after Albuterol.

Thank you so much for the help!

Up Vote Up Vote ×
Specializes in Pediatrics Retired.

I don't know about the supposed side effects but I've worked in a pedi Urgent Care for over 10 years and we mix Atrovent and Albuterol and administer in the same neb treatment.

Up Vote Up Vote ×
I don't know about the supposed side effects but I've worked in a pedi Urgent Care for over 10 years and we mix Atrovent and Albuterol and administer in the same neb treatment.

DuoNeb right? I read about this when I was trying to find the answer.

Up Vote Up Vote ×
Specializes in Pediatrics Retired.
DuoNeb right? I read about this when I was trying to find the answer.

Yes, both meds go into the neb chamber.

Up Vote Up Vote ×
Specializes in Critical Care.

The duration of action of ipratropium is 2-3 times that of albuterol, which is why duo-neb or plain ipratropium is typically given every 4-6 hours, if additional albuterol is required in between those doses then plain albuterol is used.

Keep in mind that albuterol actually contains two active ingredients; S-albuterol and R-albuterol. The R-albuterol is what provides the beneficial effects, S-albuterol is a byproduct of producing R-albuterol, S-albuterol causes bronchoconstriction and airway inflammation and appears responsible for the paradoxical effects of albuterol. Ipratropium helps treat the negative effects of albuterol, or you could just avoid the S-albuterol all together and use levalbuterol which just the beneficial R-albuterol without the harmful S-albuterol.

Up Vote Up Vote ×
+ Join the Discussion