The inhaled short-acting anticholinergic (also known as an antimuscarinic bronchodilator) ipratropium is used to provide short-term relief of asthma and mild COPD.

Dosage regimen

* Inhaled short-acting anticholinergics are taken three or four times a day.

Patient's knowledge of the medicine's use

* Anticholinergics reduce breathlessness, bronchoconstriction and mucus secretion, but the maximum effect is achieved 30-60 minutes after inhalation. For this reason, short-acting beta2 agonists (such as salbutamol) are more effective and are usually preferred.

Is the medicine working?

* Asking the following question will show how effective drug treatment is, and the impact the condition has on the patient's life:

* Has your breathing improved?

* How often do you experience shortness of breath and/or use your reliever medication?

* Does your asthma or COPD affect your social or family life?

* Do you sleep well at night?

* Ensure the patient is using their inhaler, and spacer device if applicable, correctly. A review of technique may be helpful.

Side effects

* Anticholinergics commonly cause a cough and a dry mouth. Nausea and headache can also occur.

Monitoring

* Ensure the patient knows what an asthma or COPD attack is likely to feel like, and the appropriate course of action.

Lifestyle

* Encourage patient to be more physically active and maintain a normal to improve exercise tolerance.

* Stress can cause an asthma or COPD attack: advise the patient to try relaxation techniques such as yoga, and meditation.

* The patient should be encouraged to stop smoking.

* Asthma can be triggered by certain allergens. Encourage the patient to try and identify any that affect them (for example, animal dander, pollen, fungal spores, royal jelly) and avoid them if possible.

Uzma Chaudhry, relief pharmacist, Lloydspharmacy, Oxfordshire

Go back to