Republic of the Philippines

Cebu Normal University

Osmeña Blvd. Cebu City, 6000 Philippines

College of Nursing
Center of Excellence (COE) | Level IV Re-Accredited (AACCUP)
Telephone No.: (032) 254 4837
Email: cn@cnu.edu.ph/secretary@cnunursing.org
Website: www.cnu.edu.ph
DRUG STUDY

Patient’s Initials:______________________________________ Date of Admission:_________________________________________ Diagnosis:____________________________________________

Age:__________________________________________________ Height/Weight:_____________________________________________ Clinical Intervention:
_________________________________
Sex:__________________________________________________ Ward:________ Bed No.:________ Name of Physician: __________________________________

Name of Drug Classification Mechanism of Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: Pharmacologic Ipratropium is a General Hypersensitivity to Before Administration:
Class: nonselective Indications: salbutamol, Occasionally clients may
Ipratropium bromide Ipratropium competitive ipratropium or experience headache, nausea, 1. Verify Doctor’s orders prior to
and albuterol sulfate bromide: antimuscarinic agent. It To treat clients fenoterol, atropine or dizziness and pain. administering the drug.
(salbutamol) Anticholinergic causes bronchodilation with chronic its derivatives.
Albuterol by blocking the action obstructive Adverse Effects include: 2. Introduce self to patient, and verify
Trade/Brand Name: sulfate: of acetylcholine- pulmonary Special precautions Hypersensitivity reactions patient’s identity.
Adrenergic induced stimulation of disease on a should be observed in (e.g. urticaria, angioedema,
Combipul, guanyl cyclase, hence regular aerosol Patient with CV rash, anaphylaxis, 3. Provide information about the
Combivent, Duavent reducing formation of bronchodilator disorders (e.g. bronchospasm, oropharyngeal drug, and any adverse effects.
Therapeutic cyclic guanosine who continue to ischaemic heart oedema), paradoxical Answer any questions the client
Patients’ Dose: Class: monophosphate have evidence disease, arrhythmia, bronchospasm, ocular may have.
As inhalation spray Ipratropium (cGMP) at of severe heart failure), complications (e.g. mydriasis,
releasing ipratropium bromide: parasympathetic site. bronchospasm severe airway blurred vision, narrow-angle 4. Provide baseline assessment
bromide 20 mcg and Bronchodilator Salbutamol activates and who require obstruction, cystic glaucoma, eye pain), serious including past history of allergies
salbutamol 100 Albuterol adenyl cyclase, the a second fibrosis, prostatic hypokalaemia, gastrointestinal to salbutamol, ipratropium or
mcg/actuation: 1 sulfate: enzyme that stimulates bronchodilator. hyperplasia or bladder- motility disturbances, rapidly fenoterol, atropine or its
inhalation 4 times Bronchodilator the production of cyclic neck obstruction, worsening dyspnoea, ECG derivatives. Assess if the client has
daily adenosine-3’, 5’- convulsive disorders, changes, lactic acidosis, Hypertrophic obstructive
Pregancy Risk monophosphate hyperthyroidism, urinary retention. Rarely, cardiomyopathy, tachyarrhythmia.
Route: Oral Category: C (cAMP). Increased diabetes mellitus. myocardial ischaemia. Take into consideration any special
Inhalation or Nasal cAMP leads to Pregnancy and precautions as well.
inhalation if using a activation of protein lactation.
nebulizer. kinase A, which 5. Auscultate patient’s lung sounds,
 inhibits
phosphorylation of
Form: Aerosol myosin and lowers
inhaler intracellular ionic Ca
concentrations, During
Maximum dose: 6 resulting in smooth Source: Ipratropium
inhalations per 24 muscle relaxation. bromide + Salbutamol: 1. Wash hands.
hours using an Indication, Dosage,
inhalation spray Source: Onset: Ipratropium: Side Effect, Precaution. 2. Assist the client in administering
releasing ipratropium albuterol Bronchodilation: (n.d.). Retrieved from medication, such as how to use an
bromide 20 mcg and sulfate. (n.d.). Within 15 minutes. https://www.mims.com inhaler, or a nebulizer.
salbutamol 100 Retrieved from Salbutamol: Within 5 /philippines/drug/info/
mcg/actuation https://www.glo minutes. Source: ipratropium 3. Administer the correct dosage as
wm.com/resourc Duration: Ipratropium: Combivent %20bromide%20%2B ordered by the physician. Make
Minimum dose: 1 es/glowm/cd/pa 4-8 hours. (Ipratropium %20salbutamol/ sure to space out dosages
inhalation per 24 ges/drugs/a012. Salbutamol: Approx 3- Bromide and Source: Source: Ipratropium accurately.
hours using an html 6 hours. Albuterol bromide + Salbutamol:
inhalation spray Sulfate): Uses, Indication, Dosage, Side 4. Inform the client to report for any
releasing ipratropium ipratropium Dosage, Side Effect, Precaution. (n.d.). adverse effects.
bromide 20 mcg and bromide. (n.d.). Effects, Retrieved from
salbutamol 100 Retrieved from Interactions, https://www.mims.com/philip After Administration:
mcg/actuation https://www.glo Warning. (n.d.). pines/drug/info/ ipratropium
wm.com/resourc Retrieved from %20bromide%20%2B 1. Monitor FEV1, and other
Availability: es/glowm/cd/pa https://www.rxli %20salbutamol/ pulmonary function tests, blood
ges/drugs/ij022. st.com/combive pressure, heart rate, CNS
Available as html nt- stimulation, serum glucose, serum
prescription only. drug.htm#descri K; signs and symptoms of
ption glaucoma, hypersensitivity
Metered dose inhaler reactions, urinary retention,
where each actuation shortness of breath.
meter contains 21
mcg of ipratropium 2. Further monitor for rate, depth,
bromide and 120 mcg rhythm, type of respirations;
of albuterol sulfate quality, rate of pulse. Assess lung
from the valve and Source: Ipratropium sounds for rhonchi and wheezing.
delivers 18 mcg of bromide + Salbutamol: Monitor ABG’s. Observe for
ipratropium bromide Indication, Dosage, retractions (clavicular, sternal,
and 103 mcg of Side Effect, Precaution. intercostal), hand tremor. Evaluate
albuterol sulfate (n.d.). Retrieved from for clinical improvement.
(equivalent to 90 mcg https://www.mims.com
albuterol base) from /philippines/drug/info/
the mouthpiece. ipratropium 3. Document the procedure, and any
%20bromide%20%2B interventions performed on the
Solution for %20salbutamol/ client.
nebulization
 containing
ipratropium
Drug bromide
Study Scoring 10 pts. Source: Kizior, R. J., & Hodgson, B. B.
500 mcg and
Name of Drug 1 pts. (2018). Saunders Nursing Drug Handbook
salbutamol 2.5
Classification 1 pts. 2019 E-Book. St. Louis, MO: Elsevier
mg/2.5 mL. Health Sciences.
Mechanism of Action 1 pts.
Indication 1 pts.
Content: Contains Ipratropium bromide + Salbutamol:
Contraindication
ipratropium bromide 1 pts. Indication, Dosage, Side Effect, Precaution.
Side
anf Effects
albuterol sulfate. 1 pts. (n.d.). Retrieved from
Nursing Responsibilities 3 pts. https://www.mims.com/philippines/drug/inf
Source: Combivent
Sources 1 pts. (at least 2 references) o/ ipratropium%20bromide%20%2B
(Ipratropium
Scoring System Criterion Reference: 70% %20salbutamol/
Bromide and
Albuterol Sulfate):
Uses, Dosage, Side
Effects, Interactions,
Warning. (n.d.).
Retrieved from
https://www.rxlist.co
m/combivent-
drug.htm#description

Ipratropium bromide
+ Salbutamol:
Indication, Dosage,
Side Effect,
Precaution. (n.d.).
Retrieved from
https://www.mims.co
m/philippines/drug/in
fo/ ipratropium
%20bromide
%20%2B
%20salbutamol/