Related Experiment Video
Updated: Feb 24, 2026
Dry Powder and Nebulized Aerosol Inhalation of Pharmaceuticals Delivered to Mice Using a Nose-only Exposure System
Published on: April 6, 2017
IPRATROPIUM BROMIDE FOR ACUTE ASTHMA IN CHILDREN: A RETROSPECTIVE TRIAL
Osamu Nomura1, Yoshihiko Morikawa2, Yusuke Hagiwara1
1Division of Pediatric Emergency Medicine, Tokyo Metropolitan Children's Medical Center.
Insights
Ipratropium bromide (IB) did not reduce hospital admissions for pediatric acute asthma in Japan. Further prospective studies are needed to confirm the effectiveness of this inhaled anticholinergic treatment.
Area of Science:
- Pediatric Pulmonology
- Emergency Medicine
- Pharmacology
Background:
- Inhaled anticholinergics, like ipratropium bromide (IB), combined with β2-agonists, are recognized for reducing pediatric asthma-related hospitalizations.
- The use of IB for acute asthma treatment remains infrequent in Japan.
- This study addresses the need to evaluate IB's efficacy and safety in Japanese children with acute asthma.
Purpose of the Study:
- To investigate the effectiveness of ipratropium bromide (IB) in treating pediatric acute asthma.
- To assess the safety profile of IB in this patient population.
- To compare hospital admission rates between children treated with and without IB.
Main Methods:
- A retrospective study design was employed.
- Propensity score matching was utilized to control for confounding factors in comparing patients who received IB versus those who did not.
- Patients received IB via metered-dose inhaler (40μg/dose) with a spacer, administered three times at 20-minute intervals.
Main Results:
- The study included 175 patients, with 102 in the IB group and 73 in the Non-IB group; 63 patients were matched from each group.
- No statistically significant difference in hospital admission rates was observed between the IB group (12.7%) and the Non-IB group (9.5%; p=0.78).
- One patient (1.0%) in the IB group experienced mild, self-resolving dry mouth.
Conclusions:
- Ipratropium bromide use did not lead to a reduction in hospital admission rates for pediatric acute asthma in this study.
- Potential confounding factors may have limited the interpretation of the results.
- A prospective study is recommended to further evaluate the effectiveness of IB in the Japanese pediatric population.
Background:
Inhaled anticholinergics such as ipratropium bromide (IB), when administered with β2-agonists, are effective in reducing hospital admissions of children presenting to the emergency department with moderate to severe asthma. However, treatment of acute asthma with IB is still uncommon in Japan. The aim of this study was to investigate the effectiveness and safety of IB for the treatment of pediatric acute asthma.
Methods:
We conducted a retrospective study to compare the admission rate of patients who received IB with those who did not. Patients aged 4 years or older with a history of moderate to severe attacks were included. For analysis, propensity score matching was used to adjust the confounding factors related to IB use. Patients received IB by metered-dose inhaler (40μg per dose) with a spacer three times at 20-min intervals.
Results:
Among 175 patients included in the analysis, 102 patients were treated with IB (IB group) and 73 patients were treated without IB (Non-IB group). A propensity score matching analysis extracted 63 patients from each group. There was no statistical difference between the two groups in terms of admission rate (IB group 12.7% vs Non-IB group 9.5%; p=0.78). One patient (1.0%) treated with IB experienced dryness of the mouth, which resolved spontaneously.
Conclusions:
The admission rate did not decline with IB use. Several confounding factors could have influenced and limited our results. A prospective study is needed to investigate the effectiveness of IB in Japan.
Related Concept Videos
01:20Antiasthma Drugs: Muscarinic Receptor Antagonists
Antimuscarinic agents compete with ACh for the same binding site on the muscarinic receptors. By binding to these receptors, they inhibit the downstream effects of ACh and block the parasympathetic...
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:25Antiasthma Drugs: β2-Adrenoceptor Agonists
One class of bronchodilators includes β2-adrenoceptor agonists. These agents target the β2-adrenoceptors located on bronchial smooth muscle cells. By stimulating these receptors, β2-agonists induce...
01:23Inhaled Medications
01:19Antiasthma Drugs: Leukotriene Modifiers
Leukotriene modifiers work through two distinct mechanisms:
01:24Antiasthma Drugs: Methylxanthines
Theophylline is thought to inhibit phosphodiesterase enzymes, increasing intracellular levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP). This rise in cAMP and cGMP concentrations stimulates cardiac function,...