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Does Ipratropium Bromide Lead To Thick Nasal Secretions?
Question: Hello,
I am a home health nurse working with a 14 year old child with a tracheostomy. She has Pulmacort ordered twice a day, Albuterol every 4 hours as needed, and Ipratropium Bromide every 4 hours as needed, given by nebulizer. We do not give those together as Duoneb. She has a problem with dryness, causing thick secretions, especially in the morning. We used a humidifier all night and throughout the day while in bed. We also have Saline bullets. One nurse gives the PRN medications, minus the saline bullets, on a regular schedule to thin secretions. One nurse thinks the patient doesn't need the PRN medications on schedule and that using them so regularly may be contributing to the dryness. Your thoughts? Thank you.
I am a home health nurse working with a 14 year old child with a tracheostomy. She has Pulmacort ordered twice a day, Albuterol every 4 hours as needed, and Ipratropium Bromide every 4 hours as needed, given by nebulizer. We do not give those together as Duoneb. She has a problem with dryness, causing thick secretions, especially in the morning. We used a humidifier all night and throughout the day while in bed. We also have Saline bullets. One nurse gives the PRN medications, minus the saline bullets, on a regular schedule to thin secretions. One nurse thinks the patient doesn't need the PRN medications on schedule and that using them so regularly may be contributing to the dryness. Your thoughts? Thank you.
Brief Answer:
Ipratropium could have contributed to the dryness. Saline bullets essential
Detailed Answer:
Thanks for asking on HealthcareMagic.
Ipratropium bromide is an anticholinergic drug used for the treatment of conditions with bronchoconstriction. Anticholinergics are known to reduce oral and respiratory secretions and therefore may be linked to the thick secretions and dryness. In case this is happening, you may try replacing the doses of Ipratropium with Albuterol which has a similar function but does not have this side effect.
Saline bullets or sterile normal saline given as nebulization, are essential to be given to thin out the respiratory secretions. I would not suggest humidifier in this case since the child has tracheostomy and not much of vapors may reach her through this route. A direct nebulization with normal saline should be far better. Please discuss this with the nurse who is unaware of this.
PRN means 'when necessary'. Albuterol can be used as a PRN medicine rather when you feel that there is bronchospasm, rather than giving as a scheduled dose. The nurse who might have thought that a scheduled dose of Ipratropium might have contributed to the dryness, is thinking in right lines. You may give Albuterol or Ipratropium only when needed and that would in fact be better. Saline nebulization is a must and can be given in a scheduled manner rather than as PRN.
Hope that helps. I am glad that you asked.
If you found the answer to be helpful, please close the thread with a 5 star rating and a positive review.
Regards
Dr. Kunal Saha
Ipratropium could have contributed to the dryness. Saline bullets essential
Detailed Answer:
Thanks for asking on HealthcareMagic.
Ipratropium bromide is an anticholinergic drug used for the treatment of conditions with bronchoconstriction. Anticholinergics are known to reduce oral and respiratory secretions and therefore may be linked to the thick secretions and dryness. In case this is happening, you may try replacing the doses of Ipratropium with Albuterol which has a similar function but does not have this side effect.
Saline bullets or sterile normal saline given as nebulization, are essential to be given to thin out the respiratory secretions. I would not suggest humidifier in this case since the child has tracheostomy and not much of vapors may reach her through this route. A direct nebulization with normal saline should be far better. Please discuss this with the nurse who is unaware of this.
PRN means 'when necessary'. Albuterol can be used as a PRN medicine rather when you feel that there is bronchospasm, rather than giving as a scheduled dose. The nurse who might have thought that a scheduled dose of Ipratropium might have contributed to the dryness, is thinking in right lines. You may give Albuterol or Ipratropium only when needed and that would in fact be better. Saline nebulization is a must and can be given in a scheduled manner rather than as PRN.
Hope that helps. I am glad that you asked.
If you found the answer to be helpful, please close the thread with a 5 star rating and a positive review.
Regards
Dr. Kunal Saha
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Answered by
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