Not for primary treatment of acute attack. 1000330 Nov 14, 1986 · Abstract. 125–250 micrograms as required; maximum 1 mg per day. COMBIVENT RESPIMAT (ipratropium bromide and albuterol) is indicated for use in patients with chronic obstructive pulmonary disease (COPD) on a regular aerosol bronchodilator who continue to have evidence of bronchospasm (airway narrowing) and who require a second bronchodilator. If this ATROVENT HFA can cause the narrowing of the airways to get worse (paradoxical bronchospasm) which may be life threatening. 1 Sympathomimetic, Methylxanthines, Steroids 7. Anticholinergics. Clinically this manifests as wheezing. If this occurs, DuoNeb (ipratropium bromide and albuterol sulfate) should be discontinued immediately and alternative therapy instituted. Mar 18, 2022 · Bronchospasm is a symptom of several different conditions. Food and Drug Association (FDA) for treating and preventing acute or severe bronchospasm in patients with reversible obstructive airway disease, including exercise-induced bronchospasm. However, paradoxical bronchospasm has been observed with both inhaled ipratropium bromide and albuterol products and can be life-threatening. (5. 2. 6 days ago · However, paradoxical bronchospasm has been observed with both inhaled ipratropium bromide and albuterol products and can be life-threatening. Paradoxical bronchospasm. Acute bronchospasm. Child 12–17 years. Inhaled medicines, including tiotropium bromide inhalation powder, may cause paradoxical bronchospasm. Jan 30, 2024 · However, paradoxical bronchospasm has been observed with both inhaled ipratropium bromide and albuterol products and can be life-threatening. However, just because you have one of the conditions listed above, it doesn’t necessarily mean that you’ll develop bronchospasm. It can also cause rash, itching, or serious allergic reactions involving closure of the airways. However, in Ipratropium (Atrovent) Anaphylaxis, angle-closure glaucoma, hypersensitivity reaction, paradoxical bronchospasm: Long-acting muscarinic antagonists: Aclidinium (Tudorza) Dry powder inhaler: This medicine may cause paradoxical bronchospasm, which means your breathing or wheezing will get worse. OVERDOSAGE Acute overdosage by inhalation is unlikely since ipratropium bromide is not well absorbed systemically after aerosol or oral administration. Although of established efficacy in asthma, there are no studies of the use of ipratropium in patients with chronic bronchitis. 3 Paradoxical Bronchospasm 5. than when either drug is utilized alone at its recommended. Oct 31, 2023 · However, paradoxical bronchospasm has been observed with both inhaled ipratropium bromide and albuterol products and can be life-threatening. Maintenance therapy with ipratropium has established benefits in the treatment of COPD. Life-threatening adverse effects of these drugs to take note of are paradoxical bronchospasm and anaphylaxis. ATROVENT HFA may increase eye pressure which may cause or worsen some types of glaucoma. 1% to 1%): Paradoxical bronchospasm Jul 7, 2017 · The common side effects of parasympathetic stimulation (such as dryness of the mouth and eyes, decreased sweating, visual blurring, constipation, urinary retention, impotence, tachycardia and palpitations, anxiety and restlessness) are uncommon in patients treated with ipratropium by inhaler. COMBIVENT should be discontinued immediately, the patient should be assessed and alternative therapy instituted if necessary. After priming, each actuation of the inhaler delivers 21 mcg of ipratropium bromide from the valve in 56 mg of solution and delivers 17 mcg of Paradoxical bronchospasm: Discontinue COMBIVENT RESPIMAT immediately and treat with alternative therapy if paradoxical bronchospasm occurs (5. 7. Known hypersensitivity Precautions: 1. 4) Jan 10, 2024 · Albuterol, also known as salbutamol, is approved by the U. 083%); soln for inh. If bronchospasm occurs, discontinue ipratropium/albuterol and institute alternative therapy. Paradoxical bronchospasm to salbutamol is a rare situation but can turn into a serious problem for A 22-year-old woman with mild intermittent asthma, who had no previous history of an adverse reaction to an albuterol metered-dose inhaler, developed paradoxical bronchoconstriction after inhalation of the fourth dose of an albuterol nebulizer solution. . This medicine may cause paradoxical bronchospasm, which means your breathing or wheezing will get worse. Bronchoconstrictor properties of preservatives in ipratropium bromide (Atrovent) nebuliser solution. 15761/C CRR. 3 Paradoxical Bronchospasm. INDICATION FOR USE. 3) Worsening of narrow-angle glaucoma may occur. Ipratropium bromide is an anticholinergic (parasympatholytic) agent, which blocks the muscarinic receptors of acetylcholine, and, based on animal However, paradoxical bronchospasm has been observed with both inhaled ipratropium bromide and albuterol products and can be life-threatening. Avoid excessive use. Paradoxical bronchospasm As with other inhaled medicines ATROVENT may result in paradoxical bronchospasm that may be life-threatening. If this occurs, DuoNeb should be discontinued immediately and alternative therapy instituted. Jun 7, 2023 · Paradoxical bronchospasm: Discontinue ATROVENT HFA and consider other treatments if paradoxical bronchospasm occurs Ocular effects: Use with caution in patients with narrow-angle glaucoma and instruct patients to consult a physician immediately if signs or symptoms of narrow-angle glaucoma develop ( 5. 6 ADVERSE REACTIONS . As with the β2-adrenoceptor Jun 5, 2024 · However, paradoxical bronchospasm has been observed with both inhaled ipratropium bromide and albuterol products and can be life-threatening. Theoretically, bronchodilators, such as beta‐agonist inhalers, act to ease asthma symptoms by relaxing the muscles surrounding the walls of the bronchial tubes, which relieve bronchial constriction. 5. Hyperkalemia Contraindications: 1. 1] octane, 3-(3-hydroxy-1-oxo-2-phenylpropoxy)-8-methyl8-(1-methylethyl)-, bromide monohydrate, (3-endo, 8-syn)-: a synthetic quaternary ammonium compound bronchospasm associated with COPD and is not indicated for the initial treatment of acute episodes of bronchospasm where rescue therapy is required for rapid response. 4 Worsening of Narrow-Angle Glaucoma . Clinicians should be aware of paradoxical bronchospasm as an adverse effect with common inhaler formulations containing β₂-agonists and counsel patients accordingly in the appropriate clinical setting. acute eye pain, dry throat, hypotension, palpitations, urinary retention, tachycardia, constipation, bronchospasm, including paradoxical bronchospasm have been reported with the use of ATROVENT . Dec 14, 2023 · 5. It is crucial that PCP: Severe bronchospasm in asthma or chronic obstructive pulmonary disease. Oct 9, 2018 · Removal of excipients or use of anticholinergic inhalers improved respiratory function. Apr 15, 2024 · COMBIVENT RESPIMAT is a combination of ipratropium bromide (an anticholinergic agent) and albuterol sulfate (a beta 2-adrenergic agonist) indicated for use in patients with chronic obstructive pulmonary disease (COPD) on a regular aerosol bronchodilator who continue to have evidence of bronchospasm and who require a second bronchodilator. Jun 5, 2023 · Description for Combivent. ⚠️ Requires BCEHS-specific education. Bronchospasm (asthma/reactive airway) 2. 2 Postmarketing Experience 7 DRUG INTERACTIONS 7. 12. S. oedema, oropharyngeal oedema, bronchospasm and anaphylaxis. 1987;294(6581):1197. Finally, normal findings on direct laryngoscopy Feb 17, 2024 · Learn about the side effects of ipratropium, from common to rare, for consumers and healthcare professionals. Stop using this medicine and check with your doctor right away if you have coughing, difficulty breathing, shortness of breath, or wheezing after using this medicine. The main side effects of anticholinergics like ipratropium include: a dry mouth Ipratropium bromide is a short-acting nonselective muscarinic receptor antagonist used for bronchospasm and management of chronic obstructive pulmonary disease (COPD) and acute asthma [1,2]. Mar 27, 2014 · A review of adverse reaction reports for inhaled β 2-selective, adrenergic-agonist bronchodilators between 1974 and 1988 revealed 126 reports consistent with a diagnosis of paradoxical bronchospasm associated with use of these drugs by metered-dose inhaler, and a further 58 such reports between 1983 and 1988 for these drugs delivered by Dec 9, 2021 · However, paradoxical bronchospasm has been observed with both inhaled ipratropium bromide and albuterol products and can be life-threatening. Mar 17, 2021 · Abstract. Check with your doctor right away if you or your child have coughing, difficulty breathing, or wheezing after using this medicine. The 200 inhalation unit has a net weight of 12. Ipratropium bromide is an anticholinergic bronchodilator chemically described as 8-azoniabicyclo[3. dosage. Adult. The pediatric population is more susceptible to disease and complications from bronchospasm due to children’s unique anatomy. Thus, it is used for the management of asthma and chronic obstructive pulmonary disease. If it occurs, the preparation should be discontinued immediately and alternative therapy instituted. If this occurs, ipratropium bromide and albuterol sulfate inhalation solution should be discontinued immediately and alternative therapy instituted. ATROVENT HFA is an anticholinergic and its use may increase intraocular pressure. If this happens, stop taking ATROVENT HFA at once and call your doctor or get emergency help. Additional adverse reactions identified for ATROVENT seen in clinical trials include throat irritation, stomatitis, mouth edema, and vision blurred. Paradoxical bronchospasm As with other inhalation therapy paradoxical bronchospasm may occur with an immediate increase in wheezing and shortness of breath after dosing. If paradoxical bronchospasm occurs ATROVENT should be discontinued immediately and substituted with an alternative therapy. By inhalation of nebulised solution. She experienced the same symptoms and laryngospasm with repeated inhalations of albuterol and metaproterenol nebulizer solutions that adrenergic solutions without additives cause paradoxical bronchoconstriction. Jun 26, 2023 · This medicine may cause paradoxical bronchospasm, which means your breathing or wheezing will get worse. Jan 1, 2017 · Baeza-Trinidad R (2017) Acute coronary syndrome secondary to paradoxical bronchospasm due to nebulized ipratropium bromide V olume 3(4): 2-2 Clin Case Rep Rev, 2017 doi: 10. (IP-ra-TROE-pee-um) COMMON BRAND NAME (S): Atrovent. Use with caution in patients with narrow-angle glaucoma and instruct patients to consult a Additionally, urinary retention, mydriasis, and bronchospasm, including paradoxical bronchospasm, have been reported during the post-marketing period. 9 grams. Excessive doses can occasionally cause heart attacks and a severely low level of potassium in the blood (hypokalemia). Mar 17, 2021 · He was successfully transitioned to an ipratropium rescue inhaler for asthma exacerbations. Spirometry can help the diagnosis by revealing post-bronchodilator response. Age distribution. Paradoxical Bronchospasm: In the clinical study of DuoNeb, paradoxical bronchospasm was not observed. 1) Patients with cardiovascular system disorders: Use with caution because of beta-adrenergic stimulation (5. 2) Paradoxical bronchospasm: Discontinue SPIRIVA RESPIMAT and consider other treatments if paradoxical bronchospasm occurs. 2) • Ocular effects: Advise patients to avoid spraying ineyes and to contato ct With the dosage recommended for reversibility testing during spirometry, salbutamol showed comparable bronchodilator response and paradoxical bronchospasm frequency compared to levalbuterol and ipratropium. Jun 3, 2024 · Ipratropium Bromide and Albuterol Sulfate Inhalation Solution is contraindicated in patients with a history of hypersensitivity to any of its components, or to atropine and its derivatives. 160 mcg via metered-dose inhaler (8 x Aug 23, 2022 · However, paradoxical bronchospasm has been observed with both inhaled ipratropium bromide and albuterol products and can be life-threatening. DOI: 10. Paradoxical Bronchospasm - In the clinical study of Ipratropium Bromide and Albuterol Sulfate Inhalation Solution, paradoxical bronchospasm was not observed. You are encouraged to report negative side effects of prescription drugs to the FDA. Discontinue if paradoxical IPRATROPIUM HFA INHALER - ORAL INHALATION. Ipratropium can cause bronchospasms that can be life-threatening. agonist, ipratropium bromide can produce it by various mechanisms. If this occurs, treatment with ATROVENT HFA should be stopped and other treatments considered. 2) Ocular effects: Advise patients to avoid spraying into eyes and to contact Jun 1, 2024 · This medicine may cause paradoxical bronchospasm, which means your breathing or wheezing will get worse. Dec 12, 2018 · However, paradoxical bronchospasm has been observed with both inhaled ipratropium bromide and albuterol products and can be life-threatening. In very rare instances, bronchodilators commonly used to treat bronchospasm can actually make the condition worse. 017%), albuterol (as sulfate) 2. ':' Third, our patient had no worsening of symptoms after ipratropium inhalation, which is free of additives. The most common side effects associated with ipratropium are: dry mouth, cough, headache, nausea, dizziness, and. 6. Use for maintenance treatment only; should not be used as rescue therapy. Paradoxical bronchospasm from benzalkonium chloride (BAC) preservative in albuterol nebulizer solution in a patient with acute severe asthma. Although producing bronchodilation in most patients with obstructive airways disease, it is somewhat less effective than β2-adrenoceptor agonist drugs such as salbutamol or fenoterol in patients with asthma, but is at least as effective as these agents in bronchitis. 500 mcg via nebulizer Both salbutamol and ipratropium can be combined in the same nebulizer for co-administration purposes. Albuterol is a commonly prescribed bronchodilator used for managing diverse respiratory conditions, including asthma and exercise-induced This medicine may cause paradoxical bronchospasm, which means your breathing or wheezing will get worse. ATROVENT HFA can cause the narrowing of the airways to get worse (paradoxical bronchospasm) which may be life threatening. Ipratropium use can cause paradoxical bronchospasm. COMBIVENT Inhalation Aerosol is a combination of ipratropium bromide (as the monohydrate) and albuterol sulfate. can be given under medical supervision; maximum 2 mg per day. Apr 28, 2023 · Bronchodilators are indicated for individuals that have lower than optimal airflow through the lungs. Child 1 month–5 years. It should be recognized that paradoxical bronchospasm, when associated with inhaled formulations, frequently occurs Ipratropium bromide and tiotropium bromide bronchodilate smooth muscles due to their anticholinergic effects, relaxing the smooth muscles. Ocular complications Jun 10, 2024 · However, paradoxical bronchospasm has been observed with both inhaled ipratropium bromide and albuterol products and can be life-threatening. Note: Ipratropium is a single dose, salbutamol may be repeated). Nov 5, 2010 · However, paradoxical bronchospasm has been observed with both inhaled ipratropium bromide and albuterol products and can be life-threatening. USES: Ipratropium is used to control and prevent symptoms (wheezing and shortness of breath) caused by ongoing lung disease (chronic obstructive pulmonary disease-COPD which includes bronchitis and emphysema). Adverse reaction reports consistent with May 23, 2024 · In rare cases, ipratropium bromide can cause more severe side effects, such as allergic reactions, worsening of asthma, and paradoxical bronchospasm. Feb 17, 2020 · Bronchospasm: Paradoxical bronchospasm that may be life-threatening and may occur with use of inhaled bronchodilating agents; this should be distinguished from inadequate response. May 9, 2024 · This medicine may cause paradoxical bronchospasm, which means your breathing or wheezing will get worse. The single metered aerosol doses of 10µg, 20µg, 40µg and 80µg of COMBIVENT RESPIMAT is a combination of ipratropium bromide (an anticholinergic agent) and albuterol sulfate (a beta 2-adrenergic agonist) indicated for use in patients with chronic obstructive pulmonary disease (COPD) on a regular aerosol bronchodilator who continue to have evidence of bronchospasm and who require a second bronchodilator. 1) • Patients with cardiovascular system disorders: Use with caution because of beta-adrenergic stimulation (5. Paradoxical bronchospasm may occur in a small percentage of patients who receive albuterol. May cause life-threatening paradoxical bronchospasm or hypersensitivity reactions (skin rash, itching, angioedema, hives/giant hives, laryngospasm); discontinue immediately, and use alternative However, paradoxical bronchospasm has been observed with both inhaled ipratropium bromide and albuterol products and can be life-threatening. Paradoxical Bronchospasm . Child 6–11 years. The efficacy of ipratropium was assessed by its influence on airway constrictor responses to various bronchoprovocation stimuli; effects of medication on resting (pre-challenge) pulmonary Jan 11, 2024 · However, paradoxical bronchospasm has been observed with both inhaled ipratropium bromide and albuterol products and can be life-threatening. 250 micrograms as required; maximum 1 mg per day. Paradoxical Bronchospasm: In the clinical study of Ipratropium Bromide and Albuterol Sulfate Inhalation Solution, paradoxical bronchospasm was not observed. ATROVENT HFA (ipratropium bromide HFA) Inhalation Aerosol is a prescription maintenance treatment for bronchospasm (airway narrowing) in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. Feb 17, 2020 · Bronchospasm: Paradoxical bronchospasm that may be life-threatening may occur with use of inhaled bronchodilating agents; this should be distinguished from inadequate response. As with other inhalation therapy, inhalation induced bronchoconstriction may occur with an immediate increase in wheezing after dosing. 5 Worsening of Urinary Retention 5. Bronchodilator test using fenoterol as the bronchodilator was performed on this patient and showed reductions of FEV 1 and FVC, compatible with the fenoterol-induced paradoxical bronchospasm. 2 Anticholinergics . Paradoxical bronchospasm refers to the constriction of the airways after treatment with a sympathomimetic bronchodilator. The oral median lethal dose of Apr 15, 2024 · COMBIVENT RESPIMAT is a combination of ipratropium bromide (an anticholinergic agent) and albuterol sulfate (a beta 2 -adrenergic agonist) indicated for use in patients with chronic obstructive pulmonary disease (COPD) on a regular aerosol bronchodilator who continue to have evidence of bronchospasm and who require a second bronchodilator. Classically, salbutamol (albuterol) is Ipratropium bromide (also known as Sch 1000) is a new atropine-like bronchodilator drug whose mechanism of action is via an anticholinergic pathway and may decrease cyclic guanosine monophosphate. 6 Renal Impairment . Talk to your doctor or get medical help right away if: Hypersensitivity reactions following the use of ipratropium bromide have been seen and have presented as urticaria, angioedema, rash, bronchospasm, oropharyngeal oedema and anaphylaxis. 1 Clinical Trials Experience 6. ng angioedema, bronchospasm, or anaphylaxis, occur. Premature labor 3. If paradoxical bronchospasm occurs, discontinue ipratropium and institute alternative therapy. If this occurs, it should be treated immediately with an inhaled short- acting beta 2-agonist such as albuterol. Ipratropium has been approved by the US Food and Drug Administration (FDA) for treating bronchospasms associated with chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis. Oct 5, 2020 · Salbutamol and terbutaline are short-acting β 2 adrenergic agonists that produce bronchial smooth muscle relaxation and are widely used in obstructive pulmonary diseases. ATROVENT HFA can produce paradoxical bronchospasm that can be life threatening. If this occurs, Ipratropium Bromide and Albuterol Sulfate should be discontinued immediately and alternative therapy instituted. Paradoxical Bronchospasm: COMBIVENT Inhalation Aerosol can produce paradoxical bronchospasm that can be life-threatening. Immediate hypersensitivity reactions may occur after administration of ipratropium bromide, as demonstrated by rare cases of urticaria, angioedema, rash, bronchospasm, anaphylaxis Oct 5, 2023 · Paradoxical bronchospasm: Discontinue ATROVENT HFA and consider other treatments if paradoxical bronchospasm occurs Ocular effects: Use with caution in patients with narrow-angle glaucoma and instruct patients to consult a physician immediately if signs or symptoms of narrow-angle glaucoma develop ( 5. More serious side effects are rare, but can include sudden tightening of the airways (paradoxical bronchospasm) with some inhalers. 1. Nevertheless, their use has been the cause of a paradoxical bronchoconstriction, which is a rare and potentially serious adverse reaction. 2. 5 mg/3 mL (0. George M, Joshi SV, Concepcion E, Lee H. This article reviews published reports on the efficacy of ipratropium bromide in preventing stimulus-induced bronchospasm in patients with asthma. We report a case of AMI secondary to paradoxical bronchospasm due to nebulized ipratropium bromide. Flow obstruction is affected by the See "What Are Side Effects Associated with Using Ipratropium?" Cautions. • Paradoxical bronchospasm: Discontinue COMBIVENT RESPIMAT immediately a nd treat with alternative therapy if paradoxical bronchospasm occurs (5. They are used to either reverse asthma symptoms or improve lung Feb 19, 2024 · Ipratropium is a bronchodilator medication that dilates the airways of the lungs. Some individ- VOLUME 85 NUMBER 5 Bronchospasm: Inhaled agonists 961 Birth-10 11-20 21-30 31-40 41-50 51-60 61-70 71-80 >80 AGE,YEARS FIG. 1000330 Corpus ID: 26203467; Acute coronary syndrome secondary to paradoxical bronchospasm due to nebulized ipratropium bromide @article{BaezaTrinidad2017AcuteCS, title={Acute coronary syndrome secondary to paradoxical bronchospasm due to nebulized ipratropium bromide}, author={Ram{\'o}n Baeza-Trinidad and Jos{\'e} Daniel Mosquera-Lozano}, journal={Clinical case reports and Sep 1, 2005 · In order to evaluate the risk of paradoxical bronchoconstriction, we identified four respiratory events that might have occurred within 30 min of inhalation on four test days; these were: ‘bronchospasm’, ‘other respiratory adverse events’, ‘rescue medication use’ and ‘asymptomatic drop in FEV 1 ⩾15% from baseline’. Apr 1, 2006 · Paradoxical bronchospasm (more than 12% decrease in FEV1) was seen in two (3%), one (1. Infants use different lung mechanics compared to older children, making them more prone to wheezing. A case report 1. Do not get the spray into your eyes. The mainstay of treatment is beta-2 agonists that target the smooth muscles in the bronchioles of the lung. Jan 2, 2024 · However, paradoxical bronchospasm has been observed with both inhaled ipratropium bromide and albuterol products and can be life-threatening. This is called paradoxical bronchospasm. Case Non-smoker 75 years old woman with hypertension, valvular heart disease with LVEF 45-55%, atrial fibrillation, obstructive sleep apnea- 5. Paradoxical bronchospasm may be life-threatening. 5%) and four (6%) subjects of salbutamol, ipratropium and levalbuterol groups, respectively. May 1, 1990 · In many cases, paradoxical bronchospasm associ- ated with the use of inhaled agonists resolved spon- taneously within 5 minutes to 3 hours. 3 Cimetidine, Ranitidine Cardiac arrhythmia, cardiac ischemia, cardiomyopathy, heart failure, paradoxical bronchospasm, tachycardia — Short-acting muscarinic antagonists: Ipratropium (Atrovent) Improves FEV 1: However, paradoxical bronchospasm has been observed with both inhaled ipratropium bromide and albuterol products and can be life-threatening. 4 ) Jul 28, 2010 · ATROVENT HFA Inhalation Aerosol is a pressurized metered-dose aerosol unit for oral inhalation that contains a solution of ipratropium bromide. 500 micrograms as required, doses higher than max. If this occurs, Ipratropium Bromide and Albuterol Sulfate Inhalation Solution should be discontinued immediately and alternative therapy instituted. 4 ) COMBIVENT RESPIMAT is a combination of ipratropium bromide (an anticholinergic agent) and albuterol sulfate (a beta 2-adrenergic agonist) indicated for use in patients with chronic obstructive pulmonary disease (COPD) on a regular aerosol bronchodilator who continue to have evidence of bronchospasm and who require a second bronchodilator. Uncommon (0. Treatment with tiotropium bromide inhalation powder should be stopped and other treatments considered. difficulty breathing. 15761/CCRR. Understanding the Jan 28, 2019 · Paradoxical bronchospasm: Discontinue ATROVENT HFA and consider other treatments if paradoxical bronchospasm occurs Ocular effects: Use with caution in patients with narrow-angle glaucoma and instruct patients to consult a physician immediately if signs or symptoms of narrow-angle glaucoma develop (5. Mar 17, 2021 · Paradoxical bronchospasm is one of the adverse effect listed on the package insert of fenoterol (Berotec®) but it is rarely reported. Various respiratory conditions may require bronchodilators, including asthma and chronic obstructive pulmonary disease. Use with caution in patients with myocardial ischemia. Oct 23, 2012 · Synopsis Ipratropium bromide1 is an anticholinergic bronchodilator administered by inhalation. If this occurs, ipratropium bromide and albuterol sulfate should be discontinued immediately and alternative therapy instituted. Jun 12, 2023 · Bronchospasm characteristically presents as smooth muscle constriction of the small airways. The antagonistic action of ipratropium in the lungs leads to smooth muscle relaxation by inhibiting acetylcholine-induced reflexes facilitating entry of This medicine may cause paradoxical bronchospasm, which means your breathing or wheezing will get worse. Only a few cases have described this possible atypical effect attributed directly to ~2-adrenergic stimulation. 4 Ocular Effects . Br Med J Clin Res Ed. This may be life-threatening. Of note, a history of hypersensitivity reactions or prior episodes of paradoxical bronchospasm increases the risk of a similar reaction when using ipratropium bromide. Ipratropium bromide 0. Background: Asthma could be diagnosed by its characteristic presentation. kooumgjyidxrvlghufkq