Atronase - General Information
A muscarinic antagonist structurally related to atropine but often considered safer and more effective for inhalation use. It is used for various bronchial disorders, in rhinitis, and as an antiarrhythmic.
Pharmacology of Atronase
Atronase bromide, a synthetic ammonium compound structurally similar to atropine, is used as a bronchodilator in the management of cholinergic-mediated bronchospasm associated with chronic obstructive pulmonary disease and in the treatment of rhinorrhea associated with the common cold or with allergic or nonallergic seasonal rhinitis.
Atronase for patients
Patients should be cautioned to avoid spraying the aerosol into their eyes and be advised that this may result in precipitation or worsening of narrow-angle glaucoma, mydriasis, eye pain or discomfort, temporary blurring of vision, visual halos or colored images in association with red eyes from conjunctival and corneal congestion. Patients should also be advised that should any combination of these symptoms develop, they should consult their physician immediately.
ATROVENT Inhalation Aerosol should not be used more frequently than recommended. The dose or frequency of ATROVENT Inhalation Aerosol should not be increased without patients consulting their physician. If treatment with ATROVENT Inhalation Aerosol becomes less effective for symptomatic relief, their symptoms become worse, and/or patients need to use the product more frequently than usual, medical attention should be sought immediately. The patient, if pregnant or nursing, should be advised to contact their physician about the use of ATROVENT Inhalation Aerosol. Appropriate use of ATROVENT Inhalation Aerosol includes an understanding of the way it should be administered.
Patient's Instructions for Use
Read complete instructions carefully before using.
- Insert metal canister into clear end of mouthpiece. Make sure the canister is fully and firmly inserted into the mouthpiece. The ATROVENT. Inhalation Aerosol canister is to be used only with the ATROVENT Inhalation Aerosol mouthpiece. This mouthpiece should not be used with other aerosol medications. Similarly, the canister should not be used with other mouthpieces.
- Remove green protective cap, hold canister and shake well before each use. If the cap is not present on the mouthpiece, the mouthpiece should be inspected for the presence of foreign objects before use. For optimal results, the canister should be at room temperature before use.
- It is recommended to "test-spray" ATROVENT Inhalation Aerosol three times before using for the first time and in cases where the aerosol has not been used for more than 24 hours. Avoid spraying into eyes.
- Exhale deeply through the mouth. Holding the canister, enclose mouthpiece with the lips. Keep the eyes closed because temporary blurring of vision, visual halos or colored images in association with red eyes from conjunctival and corneal congestion, precipitation or worsening of narrow-angle glaucoma, pupil dilation, or eye pain/discomfort may result if the aerosol is sprayed into the eyes.
- Inhale slowly through the mouth and at the same time firmly press once on the upended metal canister base; continue to inhale deeply.
- Hold your breath for ten seconds and then remove the mouthpiece from the mouth and exhale slowly. Wait approximately fifteen seconds, shake the inhaler again and repeat previous steps 4-6.
- Replace protective cap after use.
- Keep the mouthpiece clean. Wash with hot water. If soap is used, rinse thoroughly with plain water. Dry thoroughly before use. When dry, replace cap on the mouthpiece when not using the drug product.
- Track the number of sprays used and discard after 200 sprays. The amount of medication in each inhalation cannot be assured after 200 sprays.
- While taking ATROVENT Inhalation Aerosol, other inhaled drugs should be taken only as directed by your physician.
- If the recommended dosage does not provide relief or symptoms become worse, patients should seek immediate medical attention. Do not increase the dose or frequency of ATROVENT Inhalation Aerosol without consulting your physician.
- Note: The indented statement below is required by the Federal government's Clean Air Act for all products containing or manufactured with chlorofluorocarbons (CFCs):
This product contains trichloromonofluoromethane (CFC-11), dichlorodifluoromethane (CFC-12) and dichlorotetrafluoroethane (CFC-114), substances which harm the environment by destroying ozone in the upper atmosphere.
Your physician has determined that this product is likely to help your personal health. USE THIS PRODUCT AS DIRECTED, UNLESS INSTRUCTED TO DO OTHERWISE BY YOUR PHYSICIAN. If you have any question about alternatives, consult with your physician.
- The contents of ATROVENT Inhalation Aerosol are under pressure. Do not puncture. Do not use or store near heat or open flame. Exposure to temperatures above 120°F may cause bursting. Never throw the container into a fire or incinerator. Keep out of reach of children. Avoid spraying into eyes.
Store between 59°F (15°C) and 86°F (30°C). Avoid excessive humidity.
ATROVENT Inhalation Aerosol has been used concomitantly with other drugs, including sympathomimetic bronchodilators, methylxanthines, and steroids, commonly used in the treatment of chronic obstructive pulmonary disease. With the exception of albuterol, there are no formal studies fully evaluating the interaction effects of ATROVENT Inhalation Aerosol and these drugs with respect to effectiveness.
Anticholinergic agents: Although ipratropium bromide is minimally absorbed into the systemic circulation, there is some potential for an additive interaction with concomitantly used anticholinergic medications. Caution is therefore advised in the coadministration of ATROVENT Inhalation Aerosol with other anticholinergic-containing drugs.
ATROVENT (ipratropium bromide) Inhalation Aerosol is contraindicated in patients with a history of hypersensitivity to soya lecithin or related food products such as soybean and peanut. ATROVENT Inhalation Aerosol should also not be taken by patients hypersensitive to any other components of the drug product or to atropine or its derivatives.
Additional information about Atronase
Atronase Indication: For maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease, including chronic bronchitis and emphysema.
Mechanism Of Action: Atronase bromide is an anticholinergic agent. It blocks muscarinic cholinergic receptors, without specificity for subtypes, resulting in a decrease in the formation of cyclic guanosine monophosphate (cGMP). Most likely due to actions of cGMP on intracellular calcium, this results in decreased contractility of smooth muscle.
Drug Interactions: Not Available
Food Interactions: Not Available
Generic Name: Ipratropium
Synonyms: Ipatropium Bromide; Ipratropium Bromide; N-Isopropylatropine
Drug Category: Bronchodilator Agents; Cholinergic Antagonists; Antimuscarinics; Antispasmodics
Drug Type: Small Molecule; Approved
Other Brand Names containing Ipratropium: Aerovent; Apo-Ipravent; Apovent; Atronase; Atrovent; Atrovent Aerosol; Atrovent HFA; Atrovent Nasal; Bitrop; Disne-Asmol; Ipravent; Ipvent; Kendral-Ipratropium; Narilet; Rhinotrop; Rhinovent; Rinatec; Rinoberen; Rinovagos; Vagos;
Absorption: Inhalation (local)-minimal; Nasal-rapid and minimal
Toxicity (Overdose): LD50=1001mg/kg (orally in mice)
Protein Binding: Minimally (0 to 9% in vitro) bound to plasma albumin and a1-acid glycoproteins
Half Life: Approximately 2 hours
Dosage Forms of Atronase: Aerosol, metered Respiratory (inhalation)
Aerosol, metered Nasal
Spray, metered Nasal
Solution Respiratory (inhalation)
Liquid Respiratory (inhalation)
Chemical IUPAC Name: [(1R,5R)-8-methyl-8-propan-2-yl-8-azoniabicyclo[3.2.1]octan-3-yl] 3-hydroxy-2-phenylpropanoate
Chemical Formula: C20H30NO3+
Ipratropium on Wikipedia: http://en.wikipedia.org/wiki/Ipratropium
Organisms Affected: Humans and other mammals