Medication Card – Atrovent (Ipratropium Bromide) 아트로벤트 (이프라트로피움 브로마이드) (Kor/Eng)

Drug Classification | 약물 분류

• Therapeutic Class (치료적 분류): Bronchodilator (기관지 확장제)
• Pharmacologic Class (약리학적 분류): Anticholinergic (항콜린제), Muscarinic antagonist

 

 

 Indications | 적응증

• Maintenance treatment of bronchospasm associated with:
  • COPD (만성 폐쇄성 폐질환)
  • Chronic bronchitis (만성 기관지염)
  • Emphysema (폐기종)
• Sometimes used in asthma (천식, 보조적 치료)

 

 

 

 Therapeutic Effects | 치료 효과

• Relieves bronchospasm → 기관지 평활근 이완
• Improves airflow and breathing → 호흡 개선

 

 

 

 

 

Absorption | 흡수

• Minimal systemic absorption after inhalation (흡입 시 전신 흡수 거의 없음)

 

 

 

 

 

 Distribution | 분포

• Localized action in bronchial smooth muscle (기관지 평활근에서 국소적 작용)

 

 

 

 

 

 Protein Binding | 단백 결합률

• 낮음 (Minimal)

 

 

 

 

 

 Metabolism & Excretion | 대사 및 배설

• Partially metabolized by liver (간에서 일부 대사)
• Primarily excreted in urine (주로 신장 배설)

 

 

 

 

 

 

 

 

 ADE (Adverse Drug Effects) | 부작용

• Common (일반적): Dry mouth (구강건조), throat irritation (인후 자극), cough (기침), nausea (오심)
• Less common: Dizziness (어지럼증), blurred vision (시야흐림), headache (두통)
• Life-threatening (생명 위협): Paradoxical bronchospasm (역설적 기관지경련), hypersensitivity reaction (알레르기 반응), anaphylaxis (아나필락시스)

 

 

 

 

 

 

 

 

 Dose (예시) | 투여량

• MDI (Metered-Dose Inhaler): 2 inhalations (36 mcg) 4 times daily
• Nebulizer solution: 250–500 mcg every 6–8 hr
  (투여량은 환자 상태와 병원 프로토콜에 따라 달라짐)

 

 

 

 

 

 

 

 

 

 Nursing Considerations | 간호사 고려사항

• Assess respiratory status (호흡 상태, 폐음, 호흡곤란, 산소포화도 모니터링)
• Monitor for paradoxical bronchospasm → 호흡곤란 심해지면 즉시 중단
• Teach proper inhaler technique (흡입기 사용법 교육)
• Ensure patient rinses mouth after use (사용 후 입 헹구기 → 구강건조, 자극 완화, 감염 예방)
• Avoid contact with eyes (안구 접촉 시 동공 확장, 시야 흐림 가능)

 

 

 

 

 

 

 

 Patient Teaching | 환자 교육

•  Use inhaler regularly as prescribed (규칙적으로 사용)
•  Rinse mouth after inhalation (흡입 후 입 헹구기)
•  Do not exceed recommended dose (권장 용량 초과 금지)
•  Report worsening shortness of breath immediately (호흡곤란 악화 시 즉시 보고)
•  May take a few doses to notice improvement (효과 나타나기까지 시간이 걸릴 수 있음)

 

 

Ipratropium (i-pra-troe-pee-um)  Atrovent HFA

allergy, cold, and cough remedies, bronchodilators / anticholinergics 

● Indications:  Maintenance treatment of bronchospasm associated with: COPD (만성 폐쇄성 폐질환), Chronic bronchitis (만성 기관지염), Emphysema (폐기종)

● Therapeutic effects:  Inhaln: Bronchodilation without systemic anticholinergic effects. Intranasal: Decreased rhinorrhea

● Absorption: Minimal systemic absorption (흡입 시 전신 흡수 거의 없음) (2% for inhalation solution; 20% for inhalation aerosol; <20% following nasal use)

● Distribution: 15% of dose reaches lower airways after inhalation

● Protein binding: 

● Metabolism&Excretion: : Small amounts absorbed are metabolized by the liver

● Onset/Peak/Duration: Inhalation: Onset 1-3mins, Peak 1–2 hr, Duration 4-6 hr, Intranasal: Onset 15 min, Peak unknown, Duration 6–12 hrs

● ADE: CV: hypotension, palpitations. EENT: blurred vision, sore throat; nasal only,epistaxis, nasal dryness/irritation. GI: GI irritation, nausea. Derm: rash. Neuro: dizziness, headache, nervousness. Resp:bronchospasm,cough, Misc: allergic reactions.

● Dose: Inhaln Metered dose inhaler (nonacute)— 2 inhalations 4 times daily (not to exceed 12 inhalations/24 hr or more frequently than every 4 hr). Acute exacerbations— 4–8 puffs using a spacer deviceas needed. Via nebulization (nonacute)— 500 mcg 3– 4 times daily. Via nebulization (acute exacerbations)— 500 mcg every 30 min for 3 doses then every 2–4 hr as needed, Intranasal : 0.03% solution— 2 sprays in each nostril 2– 3 times daily(21 mcg/spray)

● contraindication: Hypersensitivity to ipratropium,atropine, belladonna, alkaloids, or bromide; Avoid use during acute bronchospasm

● nursing consideration: Assess for allergy to atropine and belladonna alkaloids, Assess respiratory status (rate, breath sounds, degree of dyspnea, pulse) before administration and at peak of medication

 

 

 

 

 요약**Atrovent (Ipratropium bromide)**은 항콜린제 기관지 확장제로, 주로 COPD, 만성 기관지염, 폐기종 환자에게 사용됩니다. 국소적 작용으로 전신 부작용은 적지만, 반드시 흡입기 사용법과 호흡 상태 모니터링이 중요합니다.