異丙托溴銨
Ipratropium Bromide
Ipratropium bromide
別名: Atrovent · DuoNeb · Combivent · Sch-1000
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
小型哺乳類
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| As a bronchodilator in rats | one puff into nebulization chamber | Inhalation | twice daily | — | 🌎 NA |
馬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Adjunctive treatment of RAO, heaves (mild to moderate disease) | 180 micrograms inhaled aerosol | Inhalation | q4-6h | 14 days | 🌎 NA |
| Adjunctive treatment of RAO/heaves (moderate to severe disease) | 90-180 micrograms inhaled via Equine Aeromask or Equine Haler | Inhalation | every 6 hours | — | 🌎 NA |
| Adjunctive treatment of foals with severe bronchospasm | 2-3 micrograms/kg via aerosol | Inhalation | q6-8h | — | 🌎 NA |
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
局部給藥（吸入）的異丙托溴銨是一種抗毒蕈鹼藥物，用於支氣管痙攣疾病的輔助治療，例如馬的復發性呼吸道阻塞（RAO）和小動物的慢性呼吸道疾病。
臨床要點：
- 異丙托溴銨是阿托品（Atropine）的四級銨衍生物。由於其高極性，它很難被吸收到全身血液循環中，也不易穿過血腦屏障，從而顯著降低了全身性抗膽鹼副作用的風險。
- 其作用時間相對較短，可能需要頻繁給藥。
- 雖然小動物的正式藥代動力學數據有限，但作為輔助支氣管擴張劑，它通常被認為是安全且有效的。
作用機轉
Ipratropium acts as a competitive antagonist of acetylcholine at muscarinic receptors in the bronchial smooth muscle.
- Mechanism: Antagonizes acetylcholine → Prevents increases in intracellular cyclic guanosine monophosphate (cGMP) → Reduces bronchial smooth muscle constriction.
- Advantage over Atropine: Unlike atropine, ipratropium does not reduce mucociliary clearance, making it highly beneficial for patients with respiratory diseases where clearing airway secretions is critical.
安全性與警告
禁忌症
- Hypersensitivity to ipratropium or other atropine derivatives
不良反應
- Tracheal or bronchial irritation (coughing)
- Allergic responses
- Mild anticholinergic effects (e.g., dry mouth, tachycardia) in rare cases
注意事項
Use with caution in conditions where antimuscarinics may be harmful, including narrow-angle glaucoma, bladder-neck obstruction, or prostatic hypertrophy. FDA Category B for pregnancy in humans; likely safe to use during nursing.
藥物交互作用
May cause additive antimuscarinic effects
May have additive therapeutic bronchodilatory effects
監測
- Clinical efficacy (improvement in respiratory rate, effort, and lung sounds)
藥物動力學
半衰期
吸收
Minimal drug is absorbed into the systemic circulation because the medication is inhaled and acts locally.
分佈
Acts locally within the respiratory tract.
代謝
Not extensively detailed in the monograph; primarily local action.
排除
In humans, the elimination half-life is about 2 hours.
過量
Overdosage is unlikely to be a cause for concern. The drug is not well absorbed orally or after inhalation. Oral LD50 values for laboratory animals were greater than 1 gram/kg.
可用產品
劑型
- Solution for Inhalation
- Aerosol for Inhalation (Metered Dose Inhaler)
人用標示
- Ipratropium Bromide Solution for Inhalation: 0.02% (500 micrograms/vial) preservative free in 25 & 60 unit-dose vials (2.5 mL UD 'nebs')
- Ipratropium Bromide Aerosol for Inhalation: each actuation delivers 17 micrograms in 12.9 grams metered dose inhaler w/mouthpiece (approx 200 inhalations); Atrovent HFA
- Combination products: DuoNeb (with albuterol as nebs), Combivent (with albuterol as MDI)
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
The solution for inhalation should be stored at room temperature and protected from light. Keep in foil pouch until time of use. The metered dose inhalers should be stored at room temperature. The solution for nebulization may be mixed with albuterol or metaproterenol if used within one hour.
飼主須知
重要提示： 此藥物不適用於治療急性氣喘發作；它是作為維持治療，以長期保持呼吸道暢通。
- 吸入器使用： 如果使用定量吸入器（MDI），即使感覺還有藥物，在按壓200次後請勿繼續使用，因為無法保證有效成分的濃度。
- 操作： 使用前請勿搖晃HFA藥罐。
- 給藥： 確保您熟悉給藥設備（例如：面罩、霧化腔）的操作，以確保您的寵物獲得完整的劑量。
VetSheet 藥物參考供合格獸醫專業人員作臨床決策輔助之用，不能取代專業判斷或廠商最新仿單。