Ipratropium bromide inhaler?

Question

my doc has given my 9 month old daughter the above inhaler cos she has a cough and a cold. i'm reading up that it's for asthma sufferers and people with lung difficiencies. is there anything else i can give her as an alternative? cough medicines etc are not working but i'm a bit sceptial about giving her this at such a young age.

Answer 1

This chap is an enthusiast in the positive sense of the word. Children under 1 years with wheeze and bronchospasm do sometimes respond to ipatropium, though it probably has no effect on cough alone. I assume he issued her with some form of spacer device with a mask in order that she could inhale it. Doses for infants have to be quite high, despite the data sheet advice. This is because however you try and administer it, most of the drug is actually lost, in addition they need quite high doses to get a response. 10 puffs 4 hourly ( 20 micrograms/ puff) would not be an unusual dose. In severe episodes when the child is breathless the drug can be used as a nebuliser solution, here the dose is 250 micrograms 4 hourly, which is equivalent to 12 puffs, and using this device a higher percentage of the  drug is almost certainly inhaled as well.

You don't say if this is a one off episode of chestiness, nor how long it has been going on for. It would also be interesting to know if there is any family history of asthma, eczema, hay fever or allergies and whether your daughter has had eczema.

If the episode has been going on for 4 weeks or more a chest X-Ray should be performed to exclude rare causes of cough.

Just to add a couple more points, the following 3 managements never really help, antibiotics, cough medicines and anti-asthma syrups.

With you adding that there is no family history and that this is a 9 day one off, in the absence of wheeze or breathlessness I would probably not have prescribed anything at all! I would however have arranged a review.

Answer 2

That is an extremely odd prescription .... the age doesn't concern me as much as why this particular drug was prescribed ....

This drug is known to have some antitussive effects ... but I am not sure how effective it is .... I surely haven't seen it used that way ... although it could be used ... and has generally no significant side effects ....  

Answer 3

Atrovent (Ipratropium Bromide) is basically a bronchodilator that dilates the bronchi in the lungs. It's often given to people suffering from COPD associated with chronic bronchitis and emphysema.

The thing I would NOT be inclined to do is give her is cough medicine, it can in some cases induce Bronchial spasm and really one should avoid giving it to people who have Asthma/other breathing issues...cough medicines are also of little help and pretty useless anyway..

With regards to your concerns,  I would be very sceptical about using alternative medicines in one so young for breathing issues. If it was me, I would stick to what the Dr has prescribed your child. The side effects are generally very mild and rare. If you are concerned, have a chat with your Dr about it, explain your concerns, then I am sure he will set your mind at rest.

edit

Yes, she may not have Asthma, but we ALL, whether we have asthma or not have the ability to wheeze and become tight chested, due to cold air, virus's etc.. bronchialdialtors can be given to people who don't have COPD and Asthma. But there will have been a need otherwise he would not have given it to her! There are MANY different reasons for being tigh chested and it is not limited to Asthma. I was just giving an example. Although It is a slightly odd prescription to give in this instance.

Go back to your Dr, and explain your concerns and do NOT listen to anyone here telling to give her alternative medicines for her breathing. This is plain dangerous.

edit

If this is a one off, and there is no family history then it is unlikely she has any underlying cause. In this instance it's strange he prescribed anything at all. But do go back to your Dr, don't withdraw any medication she has been prescribed without seeing the Dr first. After all he would have listen to her chest I presume? And maybe he did decide this medication was needed.

Answer 4

Try Decongestants and Antihistamines  

Answer 5

llevalo al veterinario

Answer 6

Ipratropium Bromide inhaler is not only given for asthma but also used to treat other chronic obstructive pulmonary disease. Since the child is small  I don't know how well the alternative medications will suit too.

Answer 7

I have been asthmatic since age 1 and can tell you that you need to call the pediatrician back if you aren't comfortable with what he/she prescribed.  There are alternatives to the inhalers but they aren't often given to children under 2 years old.  I hope you find resolution and your daughter is back to full health soon!